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Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long-term follow-up study.

Herbertsson, Pär LU ; Josefsson, Per-Olof; Hasserius, Ralph LU ; Karlsson, Caroline; Besjakov, Jack LU and Karlsson, Magnus LU (2004) In Journal of Bone and Joint Surgery. American Volume 86-A(3). p.569-574
Abstract
Background: The purpose of this study was to evaluate the incidence and the long-term results of closed uncomplicated Mason type-II and III fractures in a defined population of adults.



Methods: Seventy women and thirty men who were a mean of forty-seven years old when they sustained a fracture of the radial head or neck (a Mason type-II fracture in seventy-six patients and a Mason type-III fracture in twenty-four) were reexamined after a mean of nineteen years. Radiographic signs of degenerative changes of the elbow were recorded. The fracture had been treated with an elastic bandage or a collar and cuff sling with mobilization for forty-four individuals, with cast immobilization for thirty-four, with resection of the... (More)
Background: The purpose of this study was to evaluate the incidence and the long-term results of closed uncomplicated Mason type-II and III fractures in a defined population of adults.



Methods: Seventy women and thirty men who were a mean of forty-seven years old when they sustained a fracture of the radial head or neck (a Mason type-II fracture in seventy-six patients and a Mason type-III fracture in twenty-four) were reexamined after a mean of nineteen years. Radiographic signs of degenerative changes of the elbow were recorded. The fracture had been treated with an elastic bandage or a collar and cuff sling with mobilization for forty-four individuals, with cast immobilization for thirty-four, with resection of the radial head in nineteen, with open reduction of the radial head in two, and with a collateral ligament repair in one. Secondary excision of the radial head was performed because of residual pain in nine patients, and a neurolysis of the ulnar nerve was performed in one patient.



Results: Seventy-seven individuals had no symptoms in the injured elbow at the time of follow-up, twenty-one had occasional pain, and two had daily pain. The injured elbows had a slight flexion deficit compared with the uninjured elbows (mean and standard deviation, 138° ± 8° compared with 140° ± 7°) as well as a small extension deficit (mean and standard deviation, –4° ± 8° compared with –1° ± 6°) (p < 0.001 for both). The prevalence of degenerative changes was higher in the injured elbows than in the uninjured ones (76% compared with 16%, p < 0.001).



Conclusions: The results following uncomplicated Mason type-II and III fractures are predominantly favorable. A secondary radial head resection is usually effective for patients with an unfavorable outcome (predominantly long-standing pain).



Levels of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence. (Less)
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keywords
Fractures, Closed: epidemiology, Range of Motion, Radius Fractures: therapy, Radius Fractures: radiography, Radius Fractures: epidemiology, Radius Fractures: classification, Closed: radiography, Reoperation: statistics & numerical data, Articular, Risk Factors, Supination, Treatment Outcome, Closed: therapy, Middle Aged, Male, Incidence, Human, Hand Strength, Osteotomy: adverse effects, Postoperative: diagnosis, Pain, Osteotomy: methods, Postoperative: etiology, Pronation, Closed: classification, Internal: methods, Internal: adverse effects, Fracture Fixation, Surgical: adverse effects, Elbow Joint, Female, Follow-Up Studies, Activities of Daily Living, Adolescent, Adult, Aged, Braces: adverse effects, Casts
in
Journal of Bone and Joint Surgery. American Volume
volume
86-A
issue
3
pages
569 - 574
publisher
Journal Bone Joint Surgery Inc
external identifiers
  • pmid:14996884
  • wos:000189272900016
  • scopus:1442331346
ISSN
1535-1386
language
English
LU publication?
yes
id
e62882ee-bc0c-402c-aec4-e0a24a165609 (old id 121569)
alternative location
http://www.ejbjs.org/cgi/reprint/86/3/569
date added to LUP
2007-07-04 17:23:33
date last changed
2017-06-18 03:41:34
@article{e62882ee-bc0c-402c-aec4-e0a24a165609,
  abstract     = {Background: The purpose of this study was to evaluate the incidence and the long-term results of closed uncomplicated Mason type-II and III fractures in a defined population of adults.<br/><br>
<br/><br>
Methods: Seventy women and thirty men who were a mean of forty-seven years old when they sustained a fracture of the radial head or neck (a Mason type-II fracture in seventy-six patients and a Mason type-III fracture in twenty-four) were reexamined after a mean of nineteen years. Radiographic signs of degenerative changes of the elbow were recorded. The fracture had been treated with an elastic bandage or a collar and cuff sling with mobilization for forty-four individuals, with cast immobilization for thirty-four, with resection of the radial head in nineteen, with open reduction of the radial head in two, and with a collateral ligament repair in one. Secondary excision of the radial head was performed because of residual pain in nine patients, and a neurolysis of the ulnar nerve was performed in one patient.<br/><br>
<br/><br>
Results: Seventy-seven individuals had no symptoms in the injured elbow at the time of follow-up, twenty-one had occasional pain, and two had daily pain. The injured elbows had a slight flexion deficit compared with the uninjured elbows (mean and standard deviation, 138° ± 8° compared with 140° ± 7°) as well as a small extension deficit (mean and standard deviation, –4° ± 8° compared with –1° ± 6°) (p &lt; 0.001 for both). The prevalence of degenerative changes was higher in the injured elbows than in the uninjured ones (76% compared with 16%, p &lt; 0.001).<br/><br>
<br/><br>
Conclusions: The results following uncomplicated Mason type-II and III fractures are predominantly favorable. A secondary radial head resection is usually effective for patients with an unfavorable outcome (predominantly long-standing pain).<br/><br>
<br/><br>
Levels of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.},
  author       = {Herbertsson, Pär and Josefsson, Per-Olof and Hasserius, Ralph and Karlsson, Caroline and Besjakov, Jack and Karlsson, Magnus},
  issn         = {1535-1386},
  keyword      = {Fractures,Closed: epidemiology,Range of Motion,Radius Fractures: therapy,Radius Fractures: radiography,Radius Fractures: epidemiology,Radius Fractures: classification,Closed: radiography,Reoperation: statistics & numerical data,Articular,Risk Factors,Supination,Treatment Outcome,Closed: therapy,Middle Aged,Male,Incidence,Human,Hand Strength,Osteotomy: adverse effects,Postoperative: diagnosis,Pain,Osteotomy: methods,Postoperative: etiology,Pronation,Closed: classification,Internal: methods,Internal: adverse effects,Fracture Fixation,Surgical: adverse effects,Elbow Joint,Female,Follow-Up Studies,Activities of Daily Living,Adolescent,Adult,Aged,Braces: adverse effects,Casts},
  language     = {eng},
  number       = {3},
  pages        = {569--574},
  publisher    = {Journal Bone Joint Surgery Inc},
  series       = {Journal of Bone and Joint Surgery. American Volume},
  title        = {Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long-term follow-up study.},
  volume       = {86-A},
  year         = {2004},
}