Abstract
BackgroundThe aim of this study is to determine the functional long-term outcome after non-operative and operative treatment of radial neck fractures in adults.MethodsThirty-four consecutive patients with a mean age of 46.4 (18.0 to 63.0) years with a fracture of the radial neck who were treated between 2000 and 2014 were examined regarding the clinical and radiological outcome. Twenty patients were treated non-operatively, and 14 patients underwent surgery.ResultsAfter a mean follow-up of 5.7 (2.0 to 15.7) years, the clinical scores showed good results in both groups. The Disabilities of Arm, Shoulder and Hand score was 16.1 (0 to 71.6) in the non-operative group and 8.8 (0 to 50.8) in the operative group, respectively. The Mayo Elbow Performance Score was 80.0 (30 to 95) in the non-operative group and 82.5 (35 to 95) in the non-operative group, respectively. The initial angle of the radial head towards the shaft (RHSA) was significantly higher in the operative group in the anterior-posterior plane (12.8° [2 to 23] vs. 26.3° [1 to 90], p = 0.015). In the follow-up radiographs, the RHSA was significantly lower in the operative group (15.1° [3 to 30] vs. 10.9° [3 to 18], p = 0.043). Five patients developed 7 complications in the non-operative group, and 7 patients developed 12 complications in the operative group. Revision rates were higher in the operative groups as 1 patient received radial head resection in the non-operative (5%) group while 7 patients in the operative group (50%) needed revision surgery.ConclusionA good functional long-term outcome can be expected after operative and non-operative treatment of radial neck fractures in adults. If needed due to major displacement, open reduction is associated with a higher risk of complications and the need for revision surgery but can achieve similar clinical results.Trial registrationDRKS DRKS00012836 (retrospectively registered)
Highlights
The aim of this study is to determine the functional long-term outcome after non-operative and operative treatment of radial neck fractures in adults
Radial neck fractures are a rare entity in adults
If open reduction and osteosynthesis is needed, crossed screw osteosynthesis seems to have a lower risk of surgeryassociated complications
Summary
The aim of this study is to determine the functional long-term outcome after non-operative and operative treatment of radial neck fractures in adults. Isolated fractures of the radial neck are a rare injury of the elbow in both adults and children. In children, they account for about 5–10% of all elbow injuries [1, 2]. Radial neck fractures in adults can be classified according to Broberg-Morrey [10], which is a modification of the Mason classification [11]. A majority of isolated radial neck fractures, especially types 1 and 2 according to the Broberg-Morrey classification, can be treated by functional exercises alone, achieving excellent or good results in most patients [8, 12,13,14].
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