Mason Radial Head Fractures: Surgical Management
DOI:
https://doi.org/10.51985/JBUMDC2024411Keywords:
Implant of radial head, Mason III, Mason IV, Orthopedic surgery, Radial Head fractureAbstract
Objective: To evaluate the efficacy of radial head replacement in Mason Type III and IV radial head fracture. To evaluate the clinical outcomes of patients who received radial head replacement implant.
Study design & setting: This is a cross-sectional, analytical study, conducted in the orthopedic department of Doctor’s Hospital Kharian.
Methodology: Study was conducted from 15th April 2023 to 15th February 2024, Stability was assessed, radial head replacement was performed, and bone fragments were extracted during surgery. Radiographic evaluations were carried out to confirm the diagnosis at presentation, to determine the surgical outcome post-procedure, and during follow-up. SPSS- 22 was used for data entry and statistical analysis, Cross-tabulation and chi-square test was performed, P-value of < 0.05 was considered significant.
Results: The research comprised 70 patients, whose average age was 38.5 ± 9.4 years. Upon presentation, their mean hemoglobin level was 12.1 ± 1.5 mg/d. The mean time of the operation was recorded as 68.5 ± 18.9 minutes, with a minimum of 45 minutes and a maximum of 100 minutes. The frequency of the Mayo elbow performance score was determined using pre-validated categories: >90 for outstanding performance, 89–75 for good performance, 74–60 for fair performance, and <60 for bad performance, the study participants were divided into 38 (54.2%), 18 (25.7%), 10 (14.2%), and 4 (5.7%) groups, respectively.
Conclusion: Redo surgery and rate of infection are greater in patients who underwent surgery after 24 hours of injury as compared to patients who were operated within 24 hours.
References
1. Gruszka D, Nowak TE, Tkacz T, Wagner D, Rommens PM.
Complex radial head and neck fractures treated with modern
locking plate fixation. Journal of shoulder and elbow surgery.
2019;28(6):1130-8. doi.org/10.1016/j.jse.2018.11.056
2. Karimijashni M, Yoo S, Barnes K, Poitras S. Pre-and PostOperative Rehabilitation Interventions in Patients at Risk of
Poor Outcomes Following Knee or Hip Arthroplasty: Protocol
for Two Systematic Reviews. Advances in Rehabilitation
Science and Practice. 2023 doi.org/10.1177/27536351231170
3. Kovar FM, Jaindl M, Thalhammer G, Rupert S, Platzer P,
Endler G, Vielgut I, Kutscha-Lissberg F. Incidence and analysis
of radial head and neck fractures. World journal of orthopedics.
2013;4(2):80. doi: 10.5312/wjo.v4.i2.80
4. Burkhart KJ, Wegmann K, Müller LP, Gohlke FE. Fractures
of the radial head. Hand clinics. 2015;31(4):533-46. DOI: 10.
1016/j.hcl.2015.06.003
5. Grazette AJ, Aquilina A. Suppl-8, M5: The Assessment and
Management of Simple Elbow Dislocations. The Open
Orthopaedics Journal. 2017;11:1373. doi: 10.2174/187432500
1711011373
6. Midtgaard KS, Ruzbarsky JJ, Hackett TR, Viola RW. Elbow
fractures. Clinics in sports medicine. 2020;39(3):623-36. DOI:
10.1016/j.csm.2020.03.002
7. Hamoodi Z, Singh J, Elvey MH, Watts AC. Reliability and
validity of the Wrightington classification of elbow fracturedislocation. The Bone & Joint Journal. 2020;102(8):1041-7.
doi.org/10.1302/0301-620X.102B8.BJJ.2020.0013.R1
8. Santos CC, García BE, González EM, Campoverde MP,
Espinoza JM, Maldonado LX, Barba MC, Banegas ES. radial
head fractures, epidemiology, anatomy, mechanism of injury,
classification, imaging presentation, clinical presentation,
management and complications. epra International Journal
of Multidisciplinary Research (IJMR). 2023;9(5):125-32.
9. Hildebrand AH, Zhang B, Horner NS, King G, Khan M,
Alolabi B. Indications and outcomes of radial head excision:
a systematic review. Shoulder & elbow. 2020;12(3):193-202.
doi.org/10.1177/17585732198643
10. van der Windt AE, Langenberg LC, Colaris JW, Eygendaal
D. Which radial head fractures are best treated surgically?.
EFORT Open Reviews. 2024;9(5):413-21. doi.org/10.1530/
EOR-24-0035
11. Rahman N, Ahmad I, Anwar W, Khan JZ, Niaz QZ.
Radiological outcome of distal radius fractures undergoing
closed reduction and cast splint. KJMS. 2021;14(2):71.
doi.org/10.70520/kjms.v14i2.76
12. Hackl M, Wegmann K, Hollinger B, El-Zayat BF, Seybold
D, Gühring T, Schnetzke M, Schmidt-Horlohé K, Greiner S,
Lill H, Ellwein A. Surgical revision of radial head fractures:
a multicenter retrospective analysis of 466 cases. Journal of
Shoulder and Elbow Surgery. 2019;28(8):1457-67. doi.org/10.
1016/j.jse.2018.11.047
13. Le Mapihan M, Amsallem L, Ing D, Masméjean EH. Midterm
outcomes of a short-cemented bipolar radial head arthroplasty,
in a cohort of 56 cases with minimum 2-years follow-up.
Orthopaedics & Traumatology: Surgery & Research.
2023:103716. doi.org/10.1016/j.otsr.2023.103716
14. Delclaux S, Lebon J, Faraud A, Toulemonde J, Bonnevialle
N, Coulet B, Mansat P. Complications of radial head prostheses.
International orthopaedics. 2015;39:907-13. doi.org/10.1007
/s00264-015-2689-7
15. Van Riet RP, Van den Bekerom MP, Van Tongel A, Spross C,
Barco R, Watts AC. Radial head fractures. Shoulder & elbow.
2020;12(3):212-23.
16. Klug A, Gramlich Y, Wincheringer D, Hoffmann R, SchmidtHorlohé K. Epidemiology and treatment of radial head
fractures: a database analysis of over 70,000 inpatient cases.
The Journal of Hand Surgery. 2021;46(1):27-35. doi.org/
10.1016/j.jhsa.2020.05.029
17. Sun H, Duan J, Li F. Comparison between radial head
arthroplasty and open reduction and internal fixation in patients
with radial head fractures (modified Mason type III and IV):
a meta-analysis. European Journal of Orthopaedic Surgery &
Traumatology. 2016;26:283-91. doi.org/10.1007/s00590-016-
1739-1
18. Swensen SJ, Tyagi V, Uquillas C, Shakked RJ, Yoon RS,
Liporace FA. Maximizing outcomes in the treatment of radial
head fractures. Journal of Orthopaedics and Traumatology.
2019;20:1-9. doi.org/10.1186/s10195-019-0523-5
19. Nosenzo A, Galavotti C, Menozzi M, Garzia A, Pogliacomi
F, Calderazzi F. Acute radial head replacement with bipolar
prostheses: midterm results. European Journal of Orthopaedic
Surgery & Traumatology. 2021;31(2):309-18.
20. Viveen J, Kodde IF, Heijink A, Koenraadt KL, van den
Bekerom MP, Eygendaal D. Why does radial head arthroplasty
fail today? A systematic review of recent literature. EFORT
open reviews. 2019;4(12):659-67. doi.org/10.1302/2058-
5241.4.180099
21. Sun H, Duan J, Li F. Comparison between radial head
arthroplasty and open reduction and internal fixation in patients
with radial head fractures (modified Mason type III and IV):
a meta-analysis. European Journal of Orthopaedic Surgery &
Traumatology. 2016;26:283-91. doi.org/10.1007/s00590-016-
1739-1
22. Harrison JW, Chitre A, Lammin K, Warner JG, Hodgson SP.
Radial head fractures in adults. Current Orthopaedics.
2007;21(1):59-64. doi.org/10.1016/j.cuor.2006.10.003
23. Somerson JS, Matsen III FA. Timely recognition of total
elbow and radial head arthroplasty adverse events: an analysis
of reports to the US Food and Drug Administration. Journal
of shoulder and elbow surgery. 2019;28(3):510-9. doi.org/
10.1016/j.jse.2018.08.043
24. Swensen SJ, Tyagi V, Uquillas C, Shakked RJ, Yoon RS,
Liporace FA. Maximizing outcomes in the treatment of radial
head fractures. Journal of Orthopaedics and Traumatology.
2019;20:1-9. doi.org/10.1186/s10195-019-0523-5
25. Levy JC, Formaini NT, Kurowicki J. Outcomes and
radiographic findings of anatomic press-fit radial head
arthroplasty. Journal of Shoulder and Elbow Surgery.
2016;25(5):802-9. doi.org/10.1016/j.jse.2015.11.014
26. Lott A, Broder K, Goch A, Konda SR, Egol KA. Results after
radial head arthroplasty in unstable fractures. Journal of
Shoulder and Elbow Surgery. 2018;27(2):270-5.
27. Catellani F, De Caro F, De Biase CF, Perrino VR, Usai L,
Triolo V, Ziveri G, Fiorentino G. Radial head resection versus
arthroplasty in unrepairable comminuted fractures Mason
type III and type IV: a systematic review. BioMed research
international. 2018 Jul 16;2018. doi.org/10.1155/2018/4020625
28. Nestorson J, Josefsson PO, Adolfsson L. A radial head
prosthesis appears to be unnecessary in Mason-IV fracture
dislocation. Acta Orthopaedica. 2017;88(3):315-9.
doi.org/10.1080/17453674.2017.1293440
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