Arthroscopic Radial Head Fracture Fixation: Case Controlled Study (SS-63)

Abstract

To compare the results of Open reduction and Internal Fixation with Arthroscopic assisted Reduction and Internal Fixation of Radial Head Fractures in a prospective case-controlled study. To compare the results of Open reduction and Internal Fixation with Arthroscopic assisted Reduction and Internal Fixation of Radial Head Fractures in a prospective case-controlled study. 6 Mason Type II radial head fractures treated with Arthroscopic assisted Reduction and Internal Fixation was reviewed with age and sex matched cases of open reduction and internal fixations of similar type. Data on the Open reduction and Internal fixations were collected retrospectively. All arthroscopic surgeries were conducted as day-cases. The arthroscopic group required less analgesia, shorter hospital admissions, and had fewer complications. The average final range of movement at 1-year follow-up was 15 to 140 degrees in the arthroscopic group and 35 to 120 degrees in the open group. The Mayo Elbow Performance Score (MEPS) was 95/100 and 90/100 respectively. No acute complications were noted in the arthroscopic group, although one patient each had a radial nerve neurapraxia, superficial wound infection, and loose screw. Two patients of the arthroscopic group required secondary motion gaining operations - arthroscopic anterior capsulectomy for a fixed flexion contracture of 35 degrees, and arthroscopic radial scar excision for loss of supination. Three patients in the open group required secondary surgery - arthroscopic anterior capsulectomy for fixed flexion deformities, and one had arthroscopic radial head excision for prominent screws, loss of forearm rotation, and radiocapitellar arthrosis pain. This technique of arthroscopic fixation of Mason II radial head fractures takes slightly longer surgery time, a steeper learning curve, technically demanding and lack of adequate local expertise. However, this can result in anatomical restoration of the fracture, better range of movement and functional scores, less morbidity and analgesic requirement. Fewer complications, decreased need for secondary surgery, minimal hospital stay and a good cosmetic result puts this technique as an emerging popular option in the expanding field of minimally invasive surgery of the elbow. Level of Evidence: Therapeutic Level III.