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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

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[Indication for Radial Head Resection in Traumatology].

M Vlček¹, M Streck, I Čižmář

¹Ortopedická klinika 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha.

Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca

|September 28, 2018

Summary

Radial head resection is a viable treatment for Mason type III fractures, showing good outcomes. However, complications arise with concomitant injuries like Mason-Johnston type IV fractures or proximal ulna fractures.

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Area of Science:

Orthopedic Surgery
Traumatology
Upper Extremity Reconstruction

Background:

Radial head fractures are common elbow injuries.
Indications for radial head resection require current evaluation.
Potential complications include instability, heterotopic ossification, and nerve injury.

Purpose of the Study:

To determine current indications for radial head resection.
To evaluate functional and radiological outcomes of radial head resection in different fracture types.

Main Methods:

Retrospective study of 63 patients undergoing radial head resection (2008-2015).
Patients categorized into Mason type III (CR), Mason-Johnston type IV (CRLUX), and concomitant proximal ulna fracture (CRFR) groups.
Evaluated using DASH score, MEPS, range of motion, stability, neurological assessment, and radiological parameters.

Main Results:

Good functional outcomes (MEPS) in over 75% of patients across all groups.
Limited mobility observed in 9.1% (CR), 20% (CRLUX), and 20% (CRFR) of cases.
Complications like re-dislocation, radius proximalization, and heterotopic ossification occurred, particularly in complex fractures.

Conclusions:

Radial head resection is a safe and effective treatment for Mason type III fractures with no serious early complications.
Concomitant injuries (Mason-Johnston type IV, proximal ulna fracture) increase the risk of serious complications.
Accurate diagnosis is crucial to avoid resection in contra-indicated injuries like the 'terrible triad' or Essex-Lopresti injury.