Reoperation Rates and Costs of Radial Head Arthroplasty Versus Open Reduction and Internal Fixation of Radial Head and Neck Fractures: A Retrospective Database Study

Background: The decision between radial head arthroplasty and open reduction internal fixation in the context of a terrible triad elbow fracture-dislocation is debated. This study investigated both surgeon and patient factors associated with surgeons’ recommendations to use arthroplasty. Methods: One hundred fifty-two surgeon members of the Science of Variation Group participated. Surgeons were asked to complete an online survey that included surgeon demographics and 16 patient scenarios. The patient scenarios were randomized using 2 patient variables and 2 anatomical variables. Multilevel logistic mixed regression analysis was performed to identify surgeon and patient variables associated with recommendations for radial head arthroplasty. Results: We found that radial head replacement was recommended in 38% of the scenarios. Scenarios with older patients, with fractures of the whole head, and those involving 3 fracture fragments were independently associated with radial head replacement. Conclusion: We found that most surgeons recommended radial head fracture fixation rather than arthroplasty. Surgeons were more likely to recommend fixation for younger patients with partial articular fractures or with fractures with 3 or fewer fracture fragments. It seems that surgeons are uneasy about using a prosthesis in a young active patient.

Download Full-text

KPS Bipolar Radial Head Arthroplasty – Polyethylene Head Replacement with a Metal-covered Head. Case Study

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.2133 ◽

2018 ◽

Vol 20 (3) ◽

pp. 229-237

Author(s):

Kamila Malesa ◽

Mariusz Urban ◽

Dariusz Michalik ◽

Stanisław Pomianowski

Keyword(s):

Clinical Outcome ◽

Internal Fixation ◽

Surgical Procedures ◽

Radial Head ◽

Open Reduction ◽

Radial Head Fractures ◽

Radial Head Arthroplasty ◽

Radial Head Replacement ◽

Therapeutic Results

Radial head replacement should be indicated in all cases of radial head fractures when open reduction and internal fixation is anticipated to be difficult or impossible. Although excellent therapeutic results have been obtained, this procedure, like any other surgical procedures, may be associated with severe complications, including contractures, ossification or aseptic synovitis. In these cases, removal of the prosthetic radial head has always been a safe and popular solution producing a satisfactory clinical outcome. However, we present the case of a patient in whom the prosthesis was left in place, but the polyethylene head was replaced with a metal-covered head. The decision to perform this procedure was taken intraoperatively.

Download Full-text

Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-016-1739-1 ◽

2016 ◽

Vol 26 (3) ◽

pp. 283-291 ◽

Cited By ~ 19

Author(s):

Hao Sun ◽

Jun Duan ◽

Fengsheng Li

Keyword(s):

Internal Fixation ◽

Radial Head ◽

Open Reduction ◽

Meta Analysis ◽

Radial Head Fractures ◽

Radial Head Arthroplasty ◽

Type Iii

Download Full-text

Radial Head and Neck Fractures: Open Reduction and Internal Fixation

Fractures of the Elbow ◽

10.1007/978-3-030-22857-6_15 ◽

2019 ◽

pp. 133-140

Author(s):

Alexander M. Crespo ◽

Nirmal C. Tejwani

Keyword(s):

Internal Fixation ◽

Head And Neck ◽

Radial Head ◽

Open Reduction

Download Full-text

Open reduction and internal fixation versus radial head arthroplasty in the treatment of adult closed comminuted radial head fractures (modified Mason type III and IV)

International Orthopaedics ◽

10.1007/s00264-015-2755-1 ◽

2015 ◽

Vol 39 (8) ◽

pp. 1659-1664 ◽

Cited By ~ 16

Author(s):

Salah Al-Burdeni ◽

Yousef Abuodeh ◽

Talal Ibrahim ◽

Ghalib Ahmed

Keyword(s):

Internal Fixation ◽

Radial Head ◽

Open Reduction ◽

Radial Head Fractures ◽

Radial Head Arthroplasty ◽

Type Iii

Download Full-text

Open Reduction and Internal Fixation Versus Radial Head Arthroplasty for Mason III Radial Head Fractures: Appraising the Current Literature Evidence

Cureus ◽

10.7759/cureus.7501 ◽

2020 ◽

Author(s):

Hannah Meacher ◽

Shady Hermena ◽

Sherif Isaac

Keyword(s):

Internal Fixation ◽

Current Literature ◽

Radial Head ◽

Open Reduction ◽

Radial Head Fractures ◽

Radial Head Arthroplasty ◽

Literature Evidence

Download Full-text

Evaluation of results of fracture head and neck of radius managed by varius methods

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.055 ◽

2021 ◽

Vol 11 (2) ◽

pp. 269-273

Author(s):

Sambit Kumar Panda ◽

Surai Soren ◽

Ashok Kumar Nayak ◽

Rabindra Kumar Nayak ◽

Pravash Ranjan Parida

Keyword(s):

Internal Fixation ◽

Head And Neck ◽

Radial Head ◽

Open Reduction ◽

Soft Tissue Injuries ◽

Current Evidence ◽

Radial Head Fractures ◽

Type Iii ◽

Elbow Fractures ◽

Patient Reported

Radial head fractures are the most frequent fracture type reported around the elbow. Fractures have been documented to occur in isolation or with other associated osseous and soft tissue injuries. However, despite intensive research into these injuries, controversies still exist regarding the role of further imaging modalities, the use of non-operative management, as well as the indication and technique for operative intervention. To analyses the clinical and functional outcome of patients with head and neck fracture of radius managed by conservative method, open reduction and internal fixation, radial head prosthesis and radial head excision. This study “evaluation of results of fracture head and neck of radius managed by various methods” was carried out in M.K.C.G Medical College, Berhampur from September 2017 to October 2019. Eighty patients of radial head and neck fractures were treated and hereby included in our study. We collected records of the patients by asking the patients history and examining the patients. Essential investigations of all the patients were done. The primary outcome measures were the surgeon reported Mayo Elbow Score (MES) and the patient reported Short Musculoskeletal Function Assessment (SMFA). Current evidence supports open reduction and internal fixation of simple Mason type II fractures. For Mason type III fractures, controversy still exists regarding the optimal treatment. Studies currently show good to excellent results with radial head replacement in the majority of patients with Mason type III fractures with three or more fracture fragments.

Download Full-text