Posteriorly Displaced Radial Head Fractures May Represent the Footprint of an Elbow Dislocation or Subluxation as a Variant of Modified Mason Type ۴
Publish place: The Archives of Bone and Joint Surgery، Vol: 10، Issue: 6
Publish Year: 1401
نوع سند: مقاله ژورنالی
زبان: English
View: 150
This Paper With 6 Page And PDF Format Ready To Download
- Certificate
- من نویسنده این مقاله هستم
استخراج به نرم افزارهای پژوهشی:
شناسه ملی سند علمی:
JR_TABO-10-6_004
تاریخ نمایه سازی: 21 خرداد 1401
Abstract:
Background: The purpose of this case series is to describe surgical decision making and clinical outcomes in posteriorly displaced radial head fractures with a major fragment (more than ۵۰% of the head) located behind the humeral condyle. We also document the outcome of open reduction and internal fixation of completely displaced radial head fractures.Methods: A retrospective review of the ICUC® (Integrated Comprehensive Unchanged Complete) database was performed between ۲۰۱۲ and ۲۰۲۰. Patients were included if preoperative radiographs demonstrated a major radial head fracture fragment located posterior to the humeral condyle and a minimum of ۲-year follow-up data was available. Results: Ten patients met inclusion criteria. Two patients had an associated elbow dislocation whereas ۸ patients did not. All patients were found to have disruption of the lateral collateral ligament complex intraoperatively. Nine radial head fractures were successfully fixed with interfragmentary screws. One multi-fragmented radial head fracture could not be successfully stabilized with interfragmentary screw fixation and was resected. The average time to final followup was ۴.۸ years (range ۲.۲-۸.۱). At final follow-up, ۶ patients demonstrated radiographic evidence of a healed radial head, ۱ patient had avascular necrosis, and ۲ had post-traumatic arthritis. None demonstrated radiographic instability. The average functional score was ۰.۶۴ (SD ۰.۸۱) and pain score was ۰.۴۵ (SD ۰.۹۳). The average elbow extension was ۸ degrees (SD ۱۱), elbow flexion was ۱۳۹ degrees (SD ۶), forearm supination was ۶۰ degrees (SD ۲۷), and forearm pronation was ۶۹ degrees (SD ۳).Conclusion: Recognition of a posteriorly displaced radial head fracture is essential, as it may be an indirect sign of elbow instability. This instability should be addressed during surgical intervention. Level of evidence: IV
Keywords:
Authors
Monica Shoji
Harvard Combined Orthopaedic Residency Program, Harvard Medical School, Boston, MA, USA
Magdalena Hartwich Garcen
Orthopedics and Traumatology Department, British Hospital, Montevideo, Uruguay
Alberto A. Fernandez Dell’Oca
Orthopedics and Traumatology Department, British Hospital, Montevideo, Uruguay
Jesse Jupiter
Department of Orthopaedic Surgery, Division of Hand and Upper Extremity Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA