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The Influence of Medial Comminution in the Treatment Choice of Radial Head Fracture

G Touloupakis1, E Biancardi1, E Theodorakis2

  • 1Department of Orthopaedics and Traumatology, San Carlo Borromeo Hospital, Milan, Italy.

Malaysian Orthopaedic Journal
|January 6, 2021
PubMed

Insights

This study explored medial involvement in radial head fractures, finding radial head prostheses effective for comminuted fractures. Osteosynthesis is an option for simpler medial fractures in experienced hands.

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Skeletal Reconstruction

Background:

  • Radial head fractures are common elbow injuries.
  • Medial side involvement influences treatment decisions.
  • Retrospective analysis of treatment outcomes is crucial.

Purpose of the Study:

  • To investigate the impact of medial radial head fracture involvement on treatment selection.
  • To evaluate the efficacy of different surgical interventions based on fracture patterns.
  • To correlate fracture classification with clinical outcomes.

Main Methods:

  • Retrospective review of radial head fracture cases (May 2014 - Oct 2017).
  • Classification using Mason criteria and study-specific medial/lateral grouping.
  • Multivariate analysis of surgical procedures (prosthesis vs. osteosynthesis) and clinical outcomes (Mayo Elbow Performance scores).

Main Results:

  • Excellent or good Mayo Elbow Performance scores were achieved in 29 out of 30 patients.
  • Radial head prostheses showed satisfactory results for comminuted/multifragmentary medial fractures.
  • One patient experienced a poor outcome due to infection requiring implant removal.

Conclusions:

  • Radial head prosthesis is a viable option for complex medial radial head fractures.
  • Osteosynthesis may be considered for two-fragment medial fractures by experienced surgeons.
  • Treatment choice should be guided by fracture complexity and surgeon expertise.
Abstract

Keywords:
comminuted fractureselbow jointfracture fixationradial head fractureradial head replacement

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