Functional outcomes of radial head arthroplasty in Mason type III and IV fractures.

IF 2 Q2 ORTHOPEDICS
Shikhar Bindal, Harshaan Singh Pooni, Rajnish Garg, Deepak Jain
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引用次数: 0

Abstract

Background: Radial head fractures constitute approximately one-third of all elbow fractures, significantly impacting the young and active population. While open reduction and internal fixation is the preferred treatment for displaced fractures, its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty (RHA). RHA provides improved functional outcomes with fewer complications, yet its long-term efficacy remains a topic of debate.

Aim: To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.

Methods: A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital, Ludhiana over 32 months (January 2021-August 2023). A total of 26 patients with Mason type III and IV fractures were included, with six retrospective and 20 prospective cases. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS), elbow range of motion, pain via Visual Analog Scale, and activities of daily living at immediate postoperative, three-month, and six-month follow-ups.

Results: MEPS at 6 months follow up for 4 cases (15.38%) had good scores, and 22 cases (84.62%) had excellent scores, with a mean ± SD of 97.31 ± 6.67. Comparisons showed significant improvement from immediate post-operative to 3 months (P < 0.0001), from immediate post-operative to 6 months (P < 0.0001), and between 3 months and 6 months (P < 0.0001). None of the patients had elbow instability after radial head replacement and 22 cases (84.62%) had no complications, while 3 cases (11.54%) had a stiff elbow, and 1 case (3.85%) had heterotopic ossification.

Conclusion: RHA is an effective treatment for comminuted radial head fractures, providing stable elbow function with minimal complications.

桡骨头置换术治疗Mason III型和IV型骨折的功能效果。
背景:桡骨头骨折约占所有肘部骨折的三分之一,主要影响年轻和活跃人群。虽然切开复位内固定是移位性骨折的首选治疗方法,但其在粉碎性骨折中的高并发症发生率导致桡骨头置换术(RHA)的使用越来越多。RHA提供了改善的功能结果和更少的并发症,但其长期疗效仍然是一个有争议的话题。目的:评价桡骨头粉碎性Mason III型和IV型骨折患者行RHA联合模块化金属假体的功能预后。方法:在卢迪亚纳Dayanand医学院和医院(2021年1月- 2023年8月)进行了一项为期32个月的前瞻性和回顾性医院研究。共纳入26例Mason III型和IV型骨折患者,其中6例为回顾性病例,20例为前瞻性病例。在术后即刻、3个月和6个月的随访中,使用Mayo肘关节功能评分(MEPS)、肘关节活动范围、视觉模拟量表疼痛和日常生活活动来评估功能结果。结果:随访6个月MEPS评分良好4例(15.38%),优22例(84.62%),平均±SD为97.31±6.67。术后立即至3个月(P < 0.0001)、术后立即至6个月(P < 0.0001)、3个月至6个月(P < 0.0001)比较均有显著改善。桡骨头置换术后无肘关节不稳,22例(84.62%)无并发症发生,3例(11.54%)发生肘关节僵硬,1例(3.85%)发生异位骨化。结论:RHA是治疗粉碎性桡骨头骨折的有效方法,肘关节功能稳定,并发症少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.10
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814
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