Cirugía Ortopédica y Traumatología, Hospital Universitari de Tarragona Joan 23, Tarragona, Spain
Purpose: The aim of the study was to assess the long-term clinical and radiological outcome after early resection for radial head fractures Mason II, III and IV in patients with minimum 10 years follow-up.
Material and Methods: Between 1984 and 1998, 51 radial head excision were practiced for Mason II, III and IV radial head fractures. Finally, 27 patients (20 men, 7 women), were retrospectively reviewed. The average age at the time of injury was 37 (18 to 61) The fracture type, according the Mason classification was : 5 type II, 16 type III and 6 type IV. The mean follow-up was 16,9 years (10-24). Mayo Elbow Performance Score (MEPS), DASH test and pain score (VAS) were performed. Range of motion, strength, degenerative changes (Broberg and Morrey), carrying angle and proximal translation of the radius were evaluated.
Results: The overall outcome (Mayo Elbow Performance Score) was excellent in 22 patients (81%), good in 4 patients (15%) and fair in 1 patient (4%). Mean DASH score was 4,89 (0-30,5), and VAS averaged 0,48 (0-5). Strength was preserved in 24 cases (88%), in 2 slightly diminished and in 1 case was moderately diminished. At final follow-up 23 patients (85%) had no pain, while 2 (7%) had light pain, and 2 (7%) had intermittent moderate pain. Mean flexion of the elbow was 135° (120-145º), 5º averaged extension deficit (0-30º), pronation of the forearm averaged 83° (60-90º), and supination averaged 79° (40-90º). In 24 patients ostheoarthritic changes (grades 1-3 Broberg-Morrey), were present with no clinical relevance. Carrying angle had 7º averaged increase. Two patients needed shortening osteotomy of the ulna for proximal translation of the radius.
Conclusion: Radial head fractures Mason II-IV treated by resection arthroplasty offers excellent and good functional results in up to 96% of the patients at long-term follow-up in spite of radiographic degenerative changes present in great majority of cases. |
