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 | ||
مقاله 4، دوره 7، شماره 2، خرداد و تیر 2019، صفحه 112-117 اصل مقاله (910.81 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2018.32035.1870 | ||
نویسندگان | ||
Martin Kiechle1؛ Andreas Thannheimer1؛ Sven Hungerer2؛ Jan Friederichs1؛ Volker Bühren1؛ Christian Von Rüden* 2 | ||
1Department of Trauma Surgery, BG Trauma Center Murnau, Germany | ||
2Department of Trauma Surgery, BG Trauma Center Murnau, Germany Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria | ||
چکیده | ||
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. Level of evidence: III | ||
کلیدواژهها | ||
Broberg and Morrey؛ DASH, Outcome, Radial head fracture, Radial head resection arthroplasty | ||
مراجع | ||
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