Clinical significances of associated injuries of radial head fracture

Abstract

Objective To explore the relationship between a radial head fracture and its associated injuries and the effect of associated injuries on the treatment. Methods We retrospectively analyzed the patients with radial head fracture who had been treated from December 2013 to December 2015. The data of their gender, age, laterality, traumatic mechanisms, Mason classification of the fracture, associated injuries, and therapeutic methods were documented. Single factor correlation analysis was conducted to identify the relationship between Mason classification and number of associated injuries, and the effects of age, Mason classification and number of associated injuries on the therapeutic methods. Results The study cohort was comprised of 61 patients, including 32 men and 29 women with a male to female ratio of 1. 1∶1. They were 20 to 78 years of age(average, 40 years). Thirty-one cases had the left elbow affected, 29 the right elbow, and one bilateral elbows. There were 17 cases of Mason Type I, 30 ones of Mason Type Ⅱ, 9 ones of Mason Type Ⅲ, and 5 ones of Mason Type Ⅳ. Ligamentous injury was associated in 47 patients, coronoid fracture in 5, distal humeral fracture in 5, capitellum osteochondral defect in 17, olecranon fracture in 2, and proximal radioulnar fracture in 2. Thirty-three patients had nonoperative treatment; 26 patients received open reduction and internal fixation; one patient underwent resection; radial head replacement was used in one. Single factor correlation analysis revealed no significant associations between number of associated injuries and gender, age, or laterality(P> 0. 05), a positive correlation between severity of radial head fracture(Mason classification)and incidence of associated injuries(P< 0. 05), and significant relationships between choice of therapy and age, Mason classification and number of associated injuries(P< 0. 05). Conclusions There may be a significant relationship between the Mason type and number of the associated injuries. The more severe a radial head fracture, the more associated injuries. Age, Mason classification, and number of associated injuries may affect the choice of therapeutic methods. In the treatment of radial head fractures, associated injuries must be considered carefully to minimize their impact. The therapy should depend on the associated injuries. Key words: Elbow joint; Radial fractures; Associated injuries; Traumatic mechanisms