Surgical revision of radial head fractures: a multicenter retrospective analysis of 466 cases
Background - Radial head fractures lead to persisting disability in a considerable number of cases. This study aimed to investigate their most common revision causes and procedures. - Methods - This multicenter retrospective study reviewed the cases of 466 adult patients who had undergone surgical r...
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| Hauptverfasser: | , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
1 February 2019
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| In: |
Journal of shoulder and elbow surgery
Year: 2019, Jahrgang: 28, Heft: 8, Pages: 1457-1467 |
| ISSN: | 1532-6500 |
| DOI: | 10.1016/j.jse.2018.11.047 |
| Online-Zugang: | Verlag, Volltext: https://doi.org/10.1016/j.jse.2018.11.047 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S1058274618308759 
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| Verfasserangaben: | Michael Hackl, MD, Kilian Wegmann, MD, PhD, Boris Hollinger, MD, Bilal F. El-Zayat, MD, PhD, Dominik Seybold, MD, PhD, Thorsten Gühring, MD, PhD, Marc Schnetzke, MD, Kay Schmidt-Horlohé, MD, Stefan Greiner, MD, PhD, Helmut Lill, MD, PhD, Alexander Ellwein, MD, Michael C. Glanzmann, MD, Sebastian Siebenlist, MD, PhD, Martin Jäger, MD, Jörg Weber, MD, Lars P. Müller, MD, PhD |
MARC
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| 245 | 1 | 0 | |a Surgical revision of radial head fractures |b a multicenter retrospective analysis of 466 cases |c Michael Hackl, MD, Kilian Wegmann, MD, PhD, Boris Hollinger, MD, Bilal F. El-Zayat, MD, PhD, Dominik Seybold, MD, PhD, Thorsten Gühring, MD, PhD, Marc Schnetzke, MD, Kay Schmidt-Horlohé, MD, Stefan Greiner, MD, PhD, Helmut Lill, MD, PhD, Alexander Ellwein, MD, Michael C. Glanzmann, MD, Sebastian Siebenlist, MD, PhD, Martin Jäger, MD, Jörg Weber, MD, Lars P. Müller, MD, PhD |
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| 520 | |a Background - Radial head fractures lead to persisting disability in a considerable number of cases. This study aimed to investigate their most common revision causes and procedures. - Methods - This multicenter retrospective study reviewed the cases of 466 adult patients who had undergone surgical revision after operative or nonoperative treatment of a radial head fracture. The initial diagnosis was a Mason type I fracture in 13.0%, Mason type II fracture in 14.6%, Mason type III fracture in 22.8%, Mason type IV fracture in 20.9%, terrible-triad injury in 12.8%, Monteggia-like lesion in 13.1%, and Essex-Lopresti lesion in 2.0%. Initial treatment was nonoperative in 30.2%, open reduction and internal fixation (ORIF) in 44.9%, radial head arthroplasty in 16.6%, radial head resection in 3.7%, sole treatment of concomitant injuries in 2.6%, and fragment excision in 2.0%. Up to 3 revision causes and procedures were recorded per case. - Results - The most common complications were stiffness (67.4%), instability (36.5%), painful osteoarthritis (29.2%), ORIF related (14.8%), nonunion or necrosis (9.2%), radial head arthroplasty related (7.5%), ulnar neuropathy (6.0%), and infection (2.6%). Revision procedures frequently included arthrolysis (42.1%), arthroplasty (24.9%), implant removal (23.6%), ligament repair or reconstruction (23.0%), débridement (14.2%), repeated ORIF (8.2%), and/or radial head resection (7.7%). Mason type I or II fractures were primarily revised because of stiffness and painful osteoarthritis. Complications after Mason type III fractures were predominantly ORIF related. Fracture-dislocations showed a wide range of complications, with instability and stiffness comprising the most common causes of revision. - Conclusions - The complications of radial head fractures are characteristic to their classification. Knowledge of these findings might guide surgeons in treating these injuries and may help counsel patients accordingly. | ||
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| 650 | 4 | |a Radial head fracture | |
| 650 | 4 | |a revision | |
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| 650 | 4 | |a surgical treatment | |
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