Surgical revision of radial head fractures

• Verfasst von: Hackl, Michael [VerfasserIn]
• Verfasst von: Wegmann, Kilian [VerfasserIn]
• Verfasst von: Hollinger, Boris [VerfasserIn]
• Verfasst von: El-Zayat, Bilal F. [VerfasserIn]
• Verfasst von: Seybold, Dominik [VerfasserIn]
• Verfasst von: Gühring, Thorsten [VerfasserIn]
• Verfasst von: Schnetzke, Marc [VerfasserIn]
• Verfasst von: Schmidt-Horlohé, Kay [VerfasserIn]
• Verfasst von: Greiner, Stefan [VerfasserIn]
• Verfasst von: Lill, Helmut [VerfasserIn]
• Verfasst von: Ellwein, Alexander [VerfasserIn]
• Verfasst von: Glanzmann, Michael C. [VerfasserIn]
• Verfasst von: Siebenlist, Sebastian [VerfasserIn]
• Verfasst von: Jäger, Martin [VerfasserIn]
• Verfasst von: Weber, Jörg [VerfasserIn]
• Verfasst von: Müller, Lars P. [VerfasserIn]
• Titel: Surgical revision of radial head fractures
• Titelzusatz: a multicenter retrospective analysis of 466 cases
• Verf.angabe: Michael Hackl, MD, Kilian Wegmann, MD, PhD, Boris Hollinger, MD, Bilal F. El-Zayat, MD, PhD, Dominik Seybold, MD, PhD, Thorsten Gühring, MD, PhD, Marc Schnetzke, MD, Kay Schmidt-Horlohé, MD, Stefan Greiner, MD, PhD, Helmut Lill, MD, PhD, Alexander Ellwein, MD, Michael C. Glanzmann, MD, Sebastian Siebenlist, MD, PhD, Martin Jäger, MD, Jörg Weber, MD, Lars P. Müller, MD, PhD
• E-Jahr: 2019
• Jahr: 1 February 2019
• Umfang: 11 S.
• Fussnoten: Gesehen am 30.01.2020
• Titel Quelle: Enthalten in: Journal of shoulder and elbow surgery
• Ort Quelle: St. Louis, Mo. : Mosby, 1992
• Jahr Quelle: 2019
• Band/Heft Quelle: 28(2019), 8, Seite 1457-1467
• ISSN Quelle: 1532-6500
• DOI: doi:10.1016/j.jse.2018.11.047
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: complications
• Sach-SW: nonsurgical treatment
• Sach-SW: Radial head fracture
• Sach-SW: revision
• Sach-SW: salvage procedures
• Sach-SW: surgical treatment
• K10plus-PPN: 1688937196

Abstract

Background - Radial head fractures lead to persisting disability in a considerable number of cases. This study aimed to investigate their most common revision causes and procedures. - Methods - This multicenter retrospective study reviewed the cases of 466 adult patients who had undergone surgical revision after operative or nonoperative treatment of a radial head fracture. The initial diagnosis was a Mason type I fracture in 13.0%, Mason type II fracture in 14.6%, Mason type III fracture in 22.8%, Mason type IV fracture in 20.9%, terrible-triad injury in 12.8%, Monteggia-like lesion in 13.1%, and Essex-Lopresti lesion in 2.0%. Initial treatment was nonoperative in 30.2%, open reduction and internal fixation (ORIF) in 44.9%, radial head arthroplasty in 16.6%, radial head resection in 3.7%, sole treatment of concomitant injuries in 2.6%, and fragment excision in 2.0%. Up to 3 revision causes and procedures were recorded per case. - Results - The most common complications were stiffness (67.4%), instability (36.5%), painful osteoarthritis (29.2%), ORIF related (14.8%), nonunion or necrosis (9.2%), radial head arthroplasty related (7.5%), ulnar neuropathy (6.0%), and infection (2.6%). Revision procedures frequently included arthrolysis (42.1%), arthroplasty (24.9%), implant removal (23.6%), ligament repair or reconstruction (23.0%), débridement (14.2%), repeated ORIF (8.2%), and/or radial head resection (7.7%). Mason type I or II fractures were primarily revised because of stiffness and painful osteoarthritis. Complications after Mason type III fractures were predominantly ORIF related. Fracture-dislocations showed a wide range of complications, with instability and stiffness comprising the most common causes of revision. - Conclusions - The complications of radial head fractures are characteristic to their classification. Knowledge of these findings might guide surgeons in treating these injuries and may help counsel patients accordingly.