Surgical treatment of radial head fractures with elbow dislocation

Abstract

Objective To explore the clinical efficacy of surgical treatment for radial head fractures with elbow dislocation. Methods From October 2013 to October 2016, 22 cases of Mason-Johnston typeIVradial head fractures were performed surgical treatment. There were 14 cases of Mason typeIIfracture and 8 cases of typeIIIfracture. The patients were followed up clinically and radiographically until the fracture healing and elbow function entering the plateau stage. The Mayo Elbow Performance Score (MEPS) was used for the functional assessment. Results Nineteen cases of radial head fractures underwent internal fixation, and 3 cases underwent radial head replacement. The postoperative follow-up period ranged from 13 to 36 months with an average of 20 months. The elbow flexion and extension arc averaged (106±17)°, and the forearm rotation arc averaged (140±18)°. The X-ray films of all the patients showed that the concentric reduction of the elbow was maintained. No instability of the joint was found, and the reduction and fixation of the radial head fracture were satisfactory. The healing time of radial head fracture was 11 to 17 weeks with an average of 12. 5 weeks. No complications such as prosthesis dislocation were found after operation in the 3 cases of prosthetic replacement. At the last follow-up, MEPS was 60 to 100 points with an average of (91±7) points. The function was rated as excellent in 8 cases, good in 13 cases and poor in 1 case. There were 5 cases of elbow heterotopic ossification, 4 cases without further surgical treatment. And 1 case underwent surgical release. Conclusion Open reduction and internal fixation or radial head replacement combined with collateral ligament repair for the treatment of radial head fractures with elbow dislocation can obtain satisfactory clinical efficacy. Key words: Fractures, bone; Treatment outcome; Radial head; Elbow dislocation