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Proximal radial head fracture splint1/19/2024 All patients enrolled within our analysis were grouped according to the surgical procedure performed as follows: 15 in the RHP group, 16 in the ORIF group and 16 in the RHR group. In the end, our retrospective comparative study was based on 47 patients. Out of these 52 patients, 5 did not accept the clinical–radiological follow-up. Patients with neurological diseases or systemic comorbidities that could compromise clinical results were also excluded. Exclusion criteria included: neurovascular injuries, patients with prior elbow fractures anamnesis and the ones treated after 10 days from their trauma, elbow dislocation and fracture(s) other than RHF. 1), skeletal maturity and a minimum 12-month follow-up. Inclusion criteria included: a diagnosis of Mason type III RHF based on the assessment of anteroposterior and lateral X-rays and computed tomography, (CT) scans including 3D reconstruction of the elbow joint (Fig. At a later stage, the patients’ medical records, surgical procedures and radiographic images were collected. Patients provided informed consent for the inclusion in this retrospective study and publication of anonymized data. The research was conducted by using an Institutional Review Board-approved trauma database. The aim of our retrospective study was to compare mid-term clinical, functional and radiographic outcomes of Mason type III RHFs in adults treated by ORIF, RHP or RHR.įifty-two patients with isolated closed comminuted RHF were surgically treated at Clinical Orthopedics, University Politecnica delle Marche (AN), between January 2014 and October 2019. Currently, RHR is reserved for low demanding patients, without soft tissue and bony injuries associated or after failed alternative management. published good long-term outcomes of primary radial head resection (RHR), many works have described complications in the treatment of complex fracture. reported satisfactory mid-term functional results using RHP for unreconstructible RHFs. In a recent systematic review, Heijink et al. However, RHP has obtained a large consensus in managing comminuted fractures. Some authors suggest that ORIF should be attempted when anatomic reduction, restoration of congruity and early motion can be achieved. ![]() It is now commonly agreed that two surgical procedures should be preferred especially in young patients: ORIF or radial head prosthesis (RHP). While modified Mason type I and II are treated conservatively or by open reduction and internal fixation (ORIF), the optimum surgical solution for modified Mason type III and IV fractures is still debated in the literature, especially due to residual instability from this type of injury. Mason type I are minimally or non-displaced radial head fractures type II are marginal sector fractures with displacement type III are comminuted fractures involving the whole radial head, while type IV indicates RHFs associated with elbow dislocation. Modified Mason classification is the most accepted for articular fractures of radial head. RHFs equally affect males and females, although patient age and mechanism of trauma may vary : It usually involves a fall on an outstretched hand with the wrist extended and the pronated forearm. They represent one-third of elbow fractures and the 4% of all fractures. Radial head fractures (RHFs) constitute a significant portion of elbow traumatic injuries in adults. RHR may be suitable for elderly patients with lower functional demands as it reported good clinical results and reduced operation time. The ORIF group did not show good results with greater elbow stiffness and higher revision rate than the other two techniques. On the other hand, the ORIF group revision rate was 50% and secondary displacement was the most frequent cause of failure. Regarding complications, instability was the only cause of revision surgery in the RHP group and the RHR group. However, no statistical differences were observed in functional rating scores among the three groups. Supination was significantly better in the RHP group. ![]() Compared to ROM, flexion, extension and pronation were significantly worse in patients treated by ORIF than those in the RHP group and the RHR group. Patients treated by RHR had significantly higher mean age and shorter operation time than other two groups. At the follow-up, outcome assessment was based on radiographs, range of motion (ROM) and functional rating scores. All patients were grouped according to the surgical procedure performed: 15 in the RHP group, 16 in the ORIF group and 16 in the RHR group. The retrospective evaluation concerned 47 surgically treated patients after a mean follow-up of 53 months. This study focused on a comparison of mid-term clinical, functional and radiographic outcomes of adults treated by open reduction and internal fixation (ORIF), radial head prosthesis (RHP) and resection (RHR).
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