Resection arthroplasty for radial head fractures: Long-term follow-up.
BACKGROUND
Complex radial head fractures treated by early resection arthroplasty yield good clinical results at long-term follow-up.


METHODS
Fifty-one radial head excisions were performed for the treatment of radial head fractures. Twenty-seven patients (20 men, 7 women) were retrospectively reviewed. The mean age was 37 (range, 18-61) and their fracture types according to the Mason classification were 5 type II, 16 type III, and 6 type IV. The mean follow-up period was 17 years (range, 10-24). Patients were clinically evaluated: Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), visual analogue scale (VAS) for pain scores, and strength. Degenerative changes, proximal migration of the radius, and carrying angle were measured.


RESULTS
The overall outcome of the MEPS was 96.4 (range, 70-100), 22 patients (81%) achieving an excellent result, 4 patients a good (15%), and 1 patient a fair result (4%). The mean DASH score was 4.89, with slightly better results in the Mason II group than the Mason III and IV patients (P = .15). VAS averaged 0.48 (range, 0-10). Twenty-three patients (85%) reported no pain. The mean range of motion was from 5° to 135°. Pronation averaged 83° and supination averaged 79°. Strength was maintained in 24 cases (88%). In 24 patients, osteoarthritic changes were present without clinical relevance. Proximal migration of the radius was recorded in 7 cases. Carrying angle increased significantly by 7° (15° compared with 8°).


CONCLUSIONS
Radial head fractures treated by early resection arthroplasty offer satisfactory functional results in 96% of patients at long-term follow-up, in spite of the radiographic degenerative changes present in the great majority of cases.
Department of Orthopaedics and Traumatology, Hospital Universitari de Tarragona, Joan XXIII, Rovira and Virgili University, Tarragona, Spain. piftimie@terra.es
Petrea P
PP
Iftimie
Jaume
J
Calmet Garcia
Ignacio
I
de Loyola Garcia Forcada
Jose Eduardo
JE
Gonzalez Pedrouzo
Josep
J
Giné Gomà
D000293:Adolescent; D000328:Adult; D001178:Arthroplasty; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D055815:Young Adult; D000092464:Elbow Injuries