Functional outcome of radial head replacement in isolated radial head fractures

Authors

  • Rahul Kadam Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India
  • Chinmoy Sharma Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India
  • Santosh Pandhare Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India
  • Abhay Chhallani Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India
  • Abhishek Gupta Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India
  • Ritesh Sawant Department of Orthopaedics, MGM Medical College and Hospital, Kamothe, Navi Mumbai, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20170903

Keywords:

Radial head fracture, Radial head replacement, Mayo elbow performance scores

Abstract

Background: Proximal radial fractures are common type of fracture around the elbow joint. These commonly occur after an episode of fall on the outstretched arm. These fractures can occur in isolation or with other associated injuries. Among these comminuted radial head fractures are commonly associated with secondary injuries and instability of the elbow joint. Management of the radial head in such cases is very important in restoring stability of the elbow joint and starting early mobilization. This study will assess functional outcome of radial head replacement in isolated radial head fractures using Mayo elbow performance score.

Methods: Over a period of 24 months a total of 18 patients (male 12 and female 6) with isolated radial head fractures were included in the study. All of these patients had MASON type III fractures or above. Radial head replacement arthroplasty was done for irreparable radial head fractures and early mobilization was started. Functional outcome was calculated postoperatively with help of the Mayo elbow score on follow-up at 1, 3 and 6 month interval.

Results: On the basis of Mayo elbow performance scores, 13 patients had excellent results; 3 had good results; and 2 had fair results. Mean Mayo elbow score was 88.33 (SD 11.11) after 6 month follow up. None of the patients had elbow instability after radial head replacement.

Conclusions: Treatment of irreparable radial head fractures with radial head prosthesis along with soft-tissue reconstruction shows satisfactory results. Early mobilization of the elbow after operation is the key for restoration of elbow range of motion and function.

References

King GJ, Green DP, Hotchkiss RN, Pederson WC, Wolfe SW. Green's Operative Hand Surgery. London: Churchill Livingston; 2005.

Morrey BF. The elbow and its disorders. 3rd edition. Philadelphia: Saunders; 1993.

Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ. Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg. 2005;14(1):195–201.

Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ. The effect of radial head fracture size on elbow kinematics and stability. J Orthop Res. 2005;23(1):210–7.

Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006;88(10):2192–200.

Gebauer M, Barvencik F, Rucker AH, Rueger JM. Operative Therapie der dislozierten Radiusköpfchenfraktur. Der Unfallchirurg. 2005;108(8):669–71.

Meyer-Marcotty MV, Lahoda LU, Hahn MP, Muhr G. [Differential therapy of radial head fracture: a critical analysis based on outcome of 53 patients]. Unfallchirurg. 2002;105(6):532–9.

Lindenhovius AL, Felsch Q, Doornberg JN, Ring D, Kloen P. Open reduction and internal fixation compared with excision for unstable displaced fractures of the radial head. J Hand Surg Am. 2007;32(5):630–6.

Zwingmann J, Welzel M, Dovi-Akue D, Schmal H, Sudkamp NP, Strohm PC. Clinical results after different operative treatment methods of radial head and neck fractures: a systematic review and meta-analysis of clinical outcome. Injury. 2013;44(11):1540–50.

Kuruvilla RS, John T John JT, Joice Varghese MJ. Functional Outcomes of Radial Head Replacement as a Primary Treatment Measure in Traumatic Radial Head Fractures. Kerala J Orthop. 2016;28(1–2):53–7.

Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg. 1992;74:479–90.

Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84:1811–5.

Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83:1201–11.

Chen X, Wang SC, Cao LH, Yang GQ, Li M, Su JC. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop. 2011;35:1071–6.

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Published

2017-04-25

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Original Research Articles