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Erschienen in: MUSCULOSKELETAL SURGERY 1/2012

01.05.2012 | Original Article

Open reduction and internal fixation of radial head fractures

verfasst von: C. Iacobellis, A. Visentin, R. Aldegheri

Erschienen in: MUSCULOSKELETAL SURGERY | Sonderheft 1/2012

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Abstract

This study examines 32 patients operated for radial head fractures, mean age 48.7 years (range 26–76 years), Mason type II in 25 cases and Mason type III with 3 main fragments in 7 cases. Fractures were surgically reduced and fixed with Herbert’s (12 cases) or Osteomed (20 cases) cannulated screws. The latter have a head that is <1 mm high and are only threaded distally. Both types of screw provide compression across the fracture. In Mason type II cases, the mean MEPS score was 98.4 and the DASH score 6.8. In Mason type III cases, MEPS was 99.3 and DASH 9.5. We believe that fixation can be carried out with screws alone, which are less invasive, and that the screw heads should preferably be completely buried, to avoid stiffness in prono-supination. In addition, suturing of the annular ligament and the joint capsule is made easier by the reduced invasiveness of screws. Screw treatment is effective in non-comminuted fractures of the radial head.
Literatur
1.
Zurück zum Zitat Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132PubMedCrossRef Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132PubMedCrossRef
2.
Zurück zum Zitat Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The upper extremity collaborative group (UECG). Am J Ind Med 29:602–608PubMedCrossRef Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The upper extremity collaborative group (UECG). Am J Ind Med 29:602–608PubMedCrossRef
3.
Zurück zum Zitat Morrey BF, An KN, Chao EYS (1993) Functional evaluation of the elbow. In: Morrey BF (ed) The elbow and I disorders. WB Saunders, Philadelphia, pp 86–89 Morrey BF, An KN, Chao EYS (1993) Functional evaluation of the elbow. In: Morrey BF (ed) The elbow and I disorders. WB Saunders, Philadelphia, pp 86–89
4.
Zurück zum Zitat Zanchini M, Grasso S (1986) Misurazioni radiografiche dell’apparato locomotore. Aulo Gaggi Editore, Bologna Zanchini M, Grasso S (1986) Misurazioni radiografiche dell’apparato locomotore. Aulo Gaggi Editore, Bologna
5.
Zurück zum Zitat Böhler L (1956) Tecnica del trattamento delle fratture. Vallardi, Milano Böhler L (1956) Tecnica del trattamento delle fratture. Vallardi, Milano
6.
Zurück zum Zitat Johnston GW (1962) A follow up of one hundred cases of fracture of head of the radius with a review of the literature. Ulster Med J 31:51–56PubMed Johnston GW (1962) A follow up of one hundred cases of fracture of head of the radius with a review of the literature. Ulster Med J 31:51–56PubMed
7.
Zurück zum Zitat Goldberg I, Peylan J, Yosipovitch Z (1986) Last results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 78:675–679 Goldberg I, Peylan J, Yosipovitch Z (1986) Last results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 78:675–679
8.
Zurück zum Zitat Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases. J Bone Joint Surg Am 69:385–392PubMed Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases. J Bone Joint Surg Am 69:385–392PubMed
9.
Zurück zum Zitat Stephen IBM (1981) Excision of the radial head for closed fracture. Acta Orthop Scand 52:409–412PubMedCrossRef Stephen IBM (1981) Excision of the radial head for closed fracture. Acta Orthop Scand 52:409–412PubMedCrossRef
10.
Zurück zum Zitat Radin EL, Riseborough EJ (1966) Fractures of the radial head. A review of eighty-eight cases and analysis of the indications for excision of the radial head and non-operative treatment. J Bone Joint Surg Am 48:1055–1064PubMed Radin EL, Riseborough EJ (1966) Fractures of the radial head. A review of eighty-eight cases and analysis of the indications for excision of the radial head and non-operative treatment. J Bone Joint Surg Am 48:1055–1064PubMed
11.
Zurück zum Zitat Geel CW, Palmer AK (1992) Radial head fractures and their effect on the distal radioulnar joint. A rationale for treatment. Clin Orthop Relat Res 275:79–84PubMed Geel CW, Palmer AK (1992) Radial head fractures and their effect on the distal radioulnar joint. A rationale for treatment. Clin Orthop Relat Res 275:79–84PubMed
12.
Zurück zum Zitat Pearce MS, Gallannaugh SC (1996) Mason type II radial head fractures fixed with Herbert bone screws. J R Soc Med 89:340–344 Pearce MS, Gallannaugh SC (1996) Mason type II radial head fractures fixed with Herbert bone screws. J R Soc Med 89:340–344
13.
Zurück zum Zitat Van Glabbeek F, Van Riet R, Verstreken J (2001) Current concepts in the treatment of radial head fractures in the adult. A clinical and biomechanical approach. Acta Orthop Belg 67:430–441PubMed Van Glabbeek F, Van Riet R, Verstreken J (2001) Current concepts in the treatment of radial head fractures in the adult. A clinical and biomechanical approach. Acta Orthop Belg 67:430–441PubMed
14.
Zurück zum Zitat Rosenblatt Y, Athwal GS, Faber KJ (2008) Current recommendations for the treatment of radial head fractures. Orthop Clin N Am 39:173–185CrossRef Rosenblatt Y, Athwal GS, Faber KJ (2008) Current recommendations for the treatment of radial head fractures. Orthop Clin N Am 39:173–185CrossRef
15.
Zurück zum Zitat Khalfayan EE, Culp RW, Alexander AH (1992) Mason type II radial head fractures: operative versus nonoperative treatment. J Orthop Trauma 6:283–289PubMedCrossRef Khalfayan EE, Culp RW, Alexander AH (1992) Mason type II radial head fractures: operative versus nonoperative treatment. J Orthop Trauma 6:283–289PubMedCrossRef
16.
Zurück zum Zitat Àkesson T, Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Karlsson MK (2006) Primary nonoperative treatment of moderately displaced two-part fractures of the radial head. J Bone Joint Surg Am 88:1909–1914PubMedCrossRef Àkesson T, Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Karlsson MK (2006) Primary nonoperative treatment of moderately displaced two-part fractures of the radial head. J Bone Joint Surg Am 88:1909–1914PubMedCrossRef
17.
Zurück zum Zitat Faldini C, Pagkrati S, Grandi G, Digennaro V, Laurentani G, Faldini O, Giannini S (2006) What happens to the elbow joint after fractured radial head excision? Clinical and radiographic study at a mean 15-year follow-up. J Orthop Traumatol 7:126–130CrossRef Faldini C, Pagkrati S, Grandi G, Digennaro V, Laurentani G, Faldini O, Giannini S (2006) What happens to the elbow joint after fractured radial head excision? Clinical and radiographic study at a mean 15-year follow-up. J Orthop Traumatol 7:126–130CrossRef
18.
Zurück zum Zitat Bunker TD, Newman JH (1985) The Herbert differential pitch bone screw in displaced radial head fractures. Injury 16:621–624PubMedCrossRef Bunker TD, Newman JH (1985) The Herbert differential pitch bone screw in displaced radial head fractures. Injury 16:621–624PubMedCrossRef
19.
Zurück zum Zitat Sánchez Gomez P, Lajara Marco F, Ricón Recarey FJ, Lozano Requena JA (2010) Fracturas comminutas de la cabeza radial: estudio comparativo entre resección y fijación interna. Rev Eesp Cir Traumatol Ortop 54:280–288 Sánchez Gomez P, Lajara Marco F, Ricón Recarey FJ, Lozano Requena JA (2010) Fracturas comminutas de la cabeza radial: estudio comparativo entre resección y fijación interna. Rev Eesp Cir Traumatol Ortop 54:280–288
20.
Zurück zum Zitat Ikeda M, Yamashina Y, Kamimoto M, Oka Y (2003) Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates. J Bone Joint Surg Br 85:1040–1044PubMedCrossRef Ikeda M, Yamashina Y, Kamimoto M, Oka Y (2003) Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates. J Bone Joint Surg Br 85:1040–1044PubMedCrossRef
21.
Zurück zum Zitat Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y (2005) Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am 87:76–84PubMedCrossRef Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y (2005) Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am 87:76–84PubMedCrossRef
22.
Zurück zum Zitat Nalbantoglu U, Kocaoglu B, Gerell A, Aktas S, Guven O (2007) Open reduction and internal fixation of Mason type III head fractures with and without an associated elbow dislocation. J Hand Surg Am 32:1560–1568PubMedCrossRef Nalbantoglu U, Kocaoglu B, Gerell A, Aktas S, Guven O (2007) Open reduction and internal fixation of Mason type III head fractures with and without an associated elbow dislocation. J Hand Surg Am 32:1560–1568PubMedCrossRef
23.
Zurück zum Zitat Özkan Y, Öztürk A, Özdemir RM, Aykut S, Yalc̨in N (2009) Open reduction and internal fixation of radial head fracture. Ulus Travma Acil Cerrahi Derg 15:249–255PubMed Özkan Y, Öztürk A, Özdemir RM, Aykut S, Yalc̨in N (2009) Open reduction and internal fixation of radial head fracture. Ulus Travma Acil Cerrahi Derg 15:249–255PubMed
24.
Zurück zum Zitat Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815PubMed Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815PubMed
25.
Zurück zum Zitat Frankle MA, Koval KJ, Sanders RW, Zuckerman JD (1999) Radial head fractures associated with elbow dislocations treated by immediate stabilization and early motion. J Shoulder Elbow Surg 8:355–360PubMedCrossRef Frankle MA, Koval KJ, Sanders RW, Zuckerman JD (1999) Radial head fractures associated with elbow dislocations treated by immediate stabilization and early motion. J Shoulder Elbow Surg 8:355–360PubMedCrossRef
27.
Zurück zum Zitat Koslowsky TC, Mader K, Dargel J, Koebke J, Hellmich M, Pennig D (2007) Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques. J Bone Joint Surg Br 89:1545–1550PubMedCrossRef Koslowsky TC, Mader K, Dargel J, Koebke J, Hellmich M, Pennig D (2007) Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques. J Bone Joint Surg Br 89:1545–1550PubMedCrossRef
28.
Zurück zum Zitat Smith GR, Hotchkiss RN (1996) Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. J Shoulder Elbow Surg 5:113–117PubMedCrossRef Smith GR, Hotchkiss RN (1996) Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. J Shoulder Elbow Surg 5:113–117PubMedCrossRef
29.
Zurück zum Zitat Caputo AE, Mazzocca AD, Santoro VM (1998) The nonarticulating portion of the radial head: anatomic and clinical correlations for internal fixation. J Hand Surg Am 23:1082–1090PubMedCrossRef Caputo AE, Mazzocca AD, Santoro VM (1998) The nonarticulating portion of the radial head: anatomic and clinical correlations for internal fixation. J Hand Surg Am 23:1082–1090PubMedCrossRef
Metadaten
Titel
Open reduction and internal fixation of radial head fractures
verfasst von
C. Iacobellis
A. Visentin
R. Aldegheri
Publikationsdatum
01.05.2012
Verlag
Springer Milan
Erschienen in
MUSCULOSKELETAL SURGERY / Ausgabe Sonderheft 1/2012
Print ISSN: 2035-5106
Elektronische ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-012-0186-3

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