Long-term Outcomes after Primary Radial Head Resection Arthroplasty vs. Acute Radial Head Resection vs. Secondary Prosthetic Removal in Comminuted Radial Head Fractures

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Kiechle Martin; Thannheimer Andreas; Hungerer Sven; Friederichs Jan; Buhren Volker; Ruden Christian von

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Journal: Archives of Bone and Joint Surgery Year:2019 | Volume:7 | Issue:2 Page(s): 112-117

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Information Journal Paper

Title

Long-term Outcomes after Primary Radial Head Resection Arthroplasty vs. Acute Radial Head Resection vs. Secondary Prosthetic Removal in Comminuted Radial Head Fractures

Author(s)

Keywords

Broberg and Morrey;DASH

Outcome

Radial head fracture

Radial head resection arthroplasty

Abstract

Background: Aim of this study was to compare the clinical and radiological long-term Outcomes following operative treatment of comminuted Radial head fractures using 1) primary Radial head resection arthroplasty, 2) acute radial head resection, or 3) necessary secondary prosthetic removal. Additionally, we evaluated complex Radial head fractures combined with elbow dislocation and verified the hypothesis of whether primary Radial head resection arthroplasty could contribute to ligament healing. Methods: In a comparative retrospective cohort study between 2004 and 2014, 87 (33 female, 54 male) patients with comminuted Radial head fractures with a median age of 45 (range 18-77) years were included and followed-up clinically and radiologically. Functional results were evaluated according to MEPS, DASH, Broberg and Morrey, and VAS scores. Results: After a median range of 46 months postoperatively, 48 patients (group 1) obtained an acute Radial head resection arthroplasty (MEPS: 70 points, Broberg and Morrey: 63 points, DASH: 34 points, VAS: 3. 3 points). Twenty patients (group 2) were treated by radial head resection (MEPS: 63 points, Broberg and Morrey: 50 points, DASH: 49 points, VAS 4. 2 points) and 19 patients (group 3) needed secondary prosthesis removal (MEPS: 73 points, Broberg and Morrey: 66 points, DASH: 38 points, VAS: 2. 8 points). The overall Outcome demonstrated a trend towards better results and the Kellgren-Lawrence grade of postoperative osteoarthritis was significantly better in groups 1 and 3 compared to group 2 (P=0. 02). Conclusion: Clinical and radiological long-term results of this study demonstrate a trend towards a better Outcome after acute Radial head resection arthroplasty compared to primary radial head resection, especially in complex fractures associated with elbow dislocation. Furthermore, our results encourage the use of primary radial head replacement in cases of comminuted non-reconstructable Radial head fractures.

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References

The Best Option in Treatment of Modified Mason Type III Radial Head Fractures: Open Reduction and Internal Fixation Versus Radial Head Excision

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APA: Copy

Kiechle, Martin, Thannheimer, Andreas, Hungerer, Sven, Friederichs, Jan, Buhren, Volker, & Ruden, Christian von. (2019). Long-term Outcomes after Primary Radial Head Resection Arthroplasty vs. Acute Radial Head Resection vs. Secondary Prosthetic Removal in Comminuted Radial Head Fractures. THE ARCHIVES OF BONE AND JOINT SURGERY, 7(2), 112-117. SID. https://sid.ir/paper/750359/en

Vancouver: Copy

Kiechle Martin, Thannheimer Andreas, Hungerer Sven, Friederichs Jan, Buhren Volker, Ruden Christian von. Long-term Outcomes after Primary Radial Head Resection Arthroplasty vs. Acute Radial Head Resection vs. Secondary Prosthetic Removal in Comminuted Radial Head Fractures. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2019;7(2):112-117. Available from: https://sid.ir/paper/750359/en

IEEE: Copy

Martin Kiechle, Andreas Thannheimer, Sven Hungerer, Jan Friederichs, Volker Buhren, and Christian von Ruden, “Long-term Outcomes after Primary Radial Head Resection Arthroplasty vs. Acute Radial Head Resection vs. Secondary Prosthetic Removal in Comminuted Radial Head Fractures,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 7, no. 2, pp. 112–117, 2019, [Online]. Available: https://sid.ir/paper/750359/en

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