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Early radial head excision for displaced and comminuted radial head fractures: considerations and concerns at
Cesare Faldini1, Matteo Nanni, Danilo Leonetti
1Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy. cesare.faldini@ior.it
Objectives:
The aim of this study is to retrospectively review the outcomes of patients with comminuted radial head fractures surgically treated with early radial head excision.
Design:
Retrospective follow-up study.
Setting:
University orthopaedic trauma center.
Patients:
Forty-two patients with unilateral, isolated, closed, displaced, or comminuted radial head fracture (Mason type 2-10, Type 3-32).
Intervention:
Early radial head excision.
Main Outcome Measurements:
Patients were clinically and radiographically evaluated at an average follow-up of 18 years. The uninjured contralateral limb was used as a comparison. Clinical evaluation was rated using the Broberg and Morrey system, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and the visual analog scale (VAS) for pain.
Results:
At last follow-up, 36 patients had no complaints, whereas six admitted to occasional pain. The mean Broberg and Morrey score was 91.2 ± 6.3, and the mean Disabilities of the Arm, Shoulder and Hand score was 10.1 ± 8.8.
Conclusion:
Early radial head excision represents a viable option in case of displaced and comminuted fractures. According to the results of this study, it demonstrated a high rate of good results and patient satisfaction, a quick recovery after surgery, and a low rate of complications with durable results at long-term follow-up.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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