Classification of the transverse pattern of Mason II radial head fractures and its usefulness in arthroscopic osteosynthesis. Anatomo-surgical study

Abstract

ObjectiveThe management of Mason II fracture pattern assisted by arthroscopy is a valid technique that provides good results. The objective of this study was to draw attention to the usefulness of the location of the fracture in the head of the radius in defined quadrants with respect to the bicipital tuberosity through CT. This would help to plan the optimal forearm position to access each quadrant and foresee the specific difficulties of each one. Material and methodWe dissected 4 specimens of cryopreserved cadaver. We divided the radial head into 4 quadrants with regard to the bicipital tuberosity, objectifying the change of position in pronation and maximum supination with respect to the sigmoid cavity and neurovascular structures. ResultsThe head of the radio moves with pronosupination, so there are areas of convergence between the different quadrants. Quadrant 1 is approached in supination via an anteromedial portal. Quadrant 2 is approached in maximum pronation through a lateral portal. Quadrant 3 can be approached through lateral portals, with the forearm in neutral position and in pronation. Quadrant 4 is accessible with the forearm in a neutral position and in supination through a lateral portal. ConclusionsDepending on the location of the fracture in the head of the radius with respect to the bicipital tuberosity, we will need access through a specific arthroscopic portal, with the medial quadrants (anteromedial and posteromedial) being the most technically demanding.