Radial head fractures associated with elbow dislocations treated by immediate stabilization and early motion.
Twenty-one elbow dislocations with an associated radial head fracture were treated with immediate joint reduction, stabilization, and early range-of-motion exercises. In all cases initial treatment involved closed reduction of the ulnohumeral joint. For those cases involving minimally displaced and a few moderately displaced radial head fractures, treatment consisted of benign neglect (4 of 21). Of the more severely displaced fractures (17 of 21), 9 were treated with open-reduction internal fixation and 8 with immediate silicone head replacement. Despite radial head treatment, 6 of these cases remained unstable, prompting primary repair of collateral ligaments; 3 eventually required application of a hinged fixator as a salvage option. Results confirmed that initial radial head displacement predicts functional outcome. Our study demonstrates that fracture dislocations of the elbow demand a broad consideration of treatment options and that reconstruction of elbow stability requires either primary repair of collateral ligaments or the possible use of a hinged fixator device.
Frankle
M A
MA
Florida Orthopaedic Institute, Tampa 33617-2011, USA.
Koval
K J
KJ
Sanders
R W
RW
Zuckerman
J D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D000092464:Elbow Injuries