The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Open reduction and internal fixation versus radial head replacement for Mason type III radial head fractures

Author : LIU Jun-yang, WANG Ye-ming, YANG Jian-hua, TIAN Xu, WANG Guang-yu, ZHANG Bo, DONG Jing-ming.     
Working unit : . Department of Orthopaedic Trauma, Tianjin Hospital, Tianjin 300210, China
Page : 1856-1861.
Key words : radial head fracture, open reduction and internal fixation, radial head replacement, clinical outcome,short-term and mid-term
Abstract: [Objective] To compare the short-term and mid-term clinical outcomes of open reduction and internal fixation (ORIF) versus radial head replacement for isolated Masson type III radial head fractures. [Methods] A retrospective study was done on 52 patients who underwent surgical treatment from 2015 to 2017 for the isolated comminuted fractures of the radial head (Mason Type III) . Of them, 26 patients received ORIF, while the remaining 26 patients had prosthetic radial head replacement. The range of motion (ROM) and Broberg-Morrey score were documented for evaluation of the clinical consequences. [Results] All the 52 patients underwent successful surgical procedures without iatrogenic neurovascular injuries. The ORIF group was taken significantly longer incision and proved significantly more time-consuming than the replacement group (P<0.05) , regardless of no a statistically significant difference in intraoperative blood between the two groups (P>0.05) . Except that one patient in the ORIF group suffered from incision infection at 2 weeks postoperatively, which subsided after open drainage and dressing changes at 8 weeks after operation, no infection occurred in anyone of the remaining patients. All the 52 patients were followed up for 20~38 months with a mean of (27.824.59) months. One patient had internal implants removed and the radial head resected due to the internal fixation failure accompanied with fracture displacement at 3 months postoperatively, one patient who got ulnar nerve impingement and one who had severe limitation of motions underwent revision surgeries to release in corresponding structures in the ORIF group. To the latest follow up, 4 patients got internal implant loosening and 2 had delayed union in the ORIF group, whereas only 2 patients in the replacement group had prosthetic loosening on images. At the latest follow up, the replacement group proved significantly superior to the ORIF group in flexion- extension and internal-external rotation ROMs and the Broberg-Morrey scores (P<0.05) . [Conclusion] Compared with open reduction and internal fixation, the radial head replacement does achieve improved short-term and mid-term clinical outcomes, while accompanied with reduced complications for the isolated Mason type III radial head fracture.
summary:
Open reduction and internal fixation versus radial head replacement for Mason type III radial head fractures   
LIU Jun-yang, WANG Ye-ming, YANG Jian-hua, TIAN Xu, WANG Guang-yu, ZHANG Bo, DONG Jing-ming.
Orthop J Chin, 27(20):   1856-1861.