Comminuted fractures of the radial head and neck: is fixation to the shaft necessary?

Neumann, M; Nyffeler, R; Beck, M (2011). Comminuted fractures of the radial head and neck: is fixation to the shaft necessary? Journal of bone and joint surgery - British volume, 93(2), pp. 223-8. London: British Editorial Society of Bone and Joint Surgery 10.1302/0301-620X.93B2.24760

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Mason type III fractures of the radial head are treated by open reduction and internal fixation, resection or prosthetic joint replacement. When internal fixation is performed, fixation of the radial head to the shaft is difficult and implant-related complications are common. Furthermore, problems of devascularisation of the radial head can result from fixation of the plate to the radial neck. In a small retrospective study, the treatment of Mason type III fractures with fixation of the radial neck in 13 cases (group 2) was compared with 12 cases where no fixation was performed (group 1). The mean clinical and radiological follow-up was four years (1 to 9). The Broberg-Morrey index showed excellent results in both groups. Degenerative radiological changes were seen more frequently in group 2, and removal of the implant was necessary in seven of 13 cases. Post-operative evaluation of these two different techniques revealed similar ranges of movement and functional scores. We propose that anatomical reconstruction of the radial head without metalwork fixation to the neck is preferable, and the outcome is the same as that achieved with the conventional technique. In addition degenerative changes of the elbow joint may develop less frequently, and implant removal is not necessary.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
UniBE Contributor:	Nyffeler, Richard Walter
ISSN:	0301-620X
Publisher:	British Editorial Society of Bone and Joint Surgery
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:22
Last Modified:	05 Dec 2022 14:06
Publisher DOI:	10.1302/0301-620X.93B2.24760
PubMed ID:	21282763
Web of Science ID:	000287378300015
URI:	https://boris.unibe.ch/id/eprint/7478 (FactScience: 212741)