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A radial head prosthesis appears to be unnecessary in Mason-IV fracture dislocation

Nestorson, Jens; Josefsson, Per Olof LU and Adolfsson, Lars (2017) In Acta Orthopaedica 88(3). p.315-319
Abstract

Background and purpose — Previous reports on elbow injuries with concomitant comminute radial head fracture are difficult to interpret, since they include an array of different soft-tissue and bony injuries around the elbow. We focused on Mason-IV fracture dislocations of the elbow and retrospectively reviewed 2 treatment options: radial head resection or replacement with a radial head arthroplasty, both in combination with lateral ligament repair. Patients and methods — In Linköping, 18 consecutive patients with Mason-IV fracture dislocation and with a median age of 56 (19–79) years were treated with a radial head arthroplasty. In Malmö, 14 consecutive patients with a median age of 50 (29–70) years were treated for the same injury with... (More)

Background and purpose — Previous reports on elbow injuries with concomitant comminute radial head fracture are difficult to interpret, since they include an array of different soft-tissue and bony injuries around the elbow. We focused on Mason-IV fracture dislocations of the elbow and retrospectively reviewed 2 treatment options: radial head resection or replacement with a radial head arthroplasty, both in combination with lateral ligament repair. Patients and methods — In Linköping, 18 consecutive patients with Mason-IV fracture dislocation and with a median age of 56 (19–79) years were treated with a radial head arthroplasty. In Malmö, 14 consecutive patients with a median age of 50 (29–70) years were treated for the same injury with radial head resection. With a follow-up of at least 2 years (Linköping: median 58 months; Malmö: median 108 months), the outcome was assessed using the Mayo elbow performance score (MEPS), the Disabilities of Arm, Shoulder, and Hand questionnaire (DASH), range of movement, instability, and plain radiographs. Results — There was no statistically significant difference between the groups regarding MEPS, DASH, or range of motion. The rate of additional surgery was higher in patients treated with arthroplasty. Ulno-humeral osteoarthritis was more pronounced in the group treated with radial head resection, but the follow-up time was longer in these patients. Functional results and range of motion tally well with previous reports on similar injuries. Interpretation — Functional results did not improve by using a press-fit radial head arthroplasty in Mason-IV fracture dislocation of the elbow. Secondary osteoarthritis after resection of the radial head is a concern, but it did not affect the functional outcome during the follow-up time.

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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
88
issue
3
pages
315 - 319
publisher
Taylor & Francis
external identifiers
  • scopus:85013392465
ISSN
1745-3674
DOI
10.1080/17453674.2017.1293440
language
English
LU publication?
no
id
b19cbfdf-e131-4b9f-a7c1-9e03bc5e13ab
date added to LUP
2017-03-13 11:57:10
date last changed
2018-08-12 04:34:37
@article{b19cbfdf-e131-4b9f-a7c1-9e03bc5e13ab,
  abstract     = {<p>Background and purpose — Previous reports on elbow injuries with concomitant comminute radial head fracture are difficult to interpret, since they include an array of different soft-tissue and bony injuries around the elbow. We focused on Mason-IV fracture dislocations of the elbow and retrospectively reviewed 2 treatment options: radial head resection or replacement with a radial head arthroplasty, both in combination with lateral ligament repair. Patients and methods — In Linköping, 18 consecutive patients with Mason-IV fracture dislocation and with a median age of 56 (19–79) years were treated with a radial head arthroplasty. In Malmö, 14 consecutive patients with a median age of 50 (29–70) years were treated for the same injury with radial head resection. With a follow-up of at least 2 years (Linköping: median 58 months; Malmö: median 108 months), the outcome was assessed using the Mayo elbow performance score (MEPS), the Disabilities of Arm, Shoulder, and Hand questionnaire (DASH), range of movement, instability, and plain radiographs. Results — There was no statistically significant difference between the groups regarding MEPS, DASH, or range of motion. The rate of additional surgery was higher in patients treated with arthroplasty. Ulno-humeral osteoarthritis was more pronounced in the group treated with radial head resection, but the follow-up time was longer in these patients. Functional results and range of motion tally well with previous reports on similar injuries. Interpretation — Functional results did not improve by using a press-fit radial head arthroplasty in Mason-IV fracture dislocation of the elbow. Secondary osteoarthritis after resection of the radial head is a concern, but it did not affect the functional outcome during the follow-up time.</p>},
  author       = {Nestorson, Jens and Josefsson, Per Olof and Adolfsson, Lars},
  issn         = {1745-3674},
  language     = {eng},
  month        = {02},
  number       = {3},
  pages        = {315--319},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {A radial head prosthesis appears to be unnecessary in Mason-IV fracture dislocation},
  url          = {http://dx.doi.org/10.1080/17453674.2017.1293440},
  volume       = {88},
  year         = {2017},
}