title: Repairing the annular ligament is not necessary in the operation of Mason type 2, 3 isolated radial head fractures if the lateral collateral ligament is intact: Minimum 5 years follow-up.
abstract: BACKGROUND
  The repair of annular ligament after open reduction and internal fixation of radial head fracture could produce the irritation or crepitation during range of motion exercise. The purpose of this study is to evaluate the significance of unrepaired annular ligament during fixation of isolated radial head fractures.
  
  
  METHODS
  Retrospectively we reviewed the twenty-five patients who underwent surgical fixation with a plate for Mason type 2, 3 isolated radial head fracture without annular ligament repair. All the radial head fracture did not have the associated injuries which could cause the elbow instabilities. The average length of follow-up was 6.9 years. The outcomes were evaluated clinically (range of motions, instabilities, pain VAS, Broberg & Murrey functional rating score, DASH score) and radiographically (bony union, arthritic change, lateral translation of the radial head, humero-ulnar angle with maximum varus stress of elbow, ulnar variance).
  
  
  RESULTS
  The range of motions between affected and contralateral side were not significantly different at last follow-up. No one showed the instabilities of elbow. The mean pain VAS, Broberg & Murrey functional rating score, and DASH score were 2.7±0.5, 95.3±2.5, and 14.8±5.3 points respectively. Bony union was observed for all cases. There was no significant difference in the lateral translation of the radial head, humero-ulnar angle with maximum varus stress of elbow, and ulnar variance between the affected and the contralateral arm.
  
  
  CONCLUSIONS
  The isolated role of the annular ligament seems overestimated. We scrutinize that the annular ligament repair is not essential in the operative treatment of isolated radial head fractures if the lateral collateral ligament is intact.
authors.affiliation: Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Gyeonggi-do 463-712, Republic of Korea.
authors.forename: Soo Hong
authors.initials: SH
authors.lastname: Han
authors.forename: Soon Chul
authors.initials: SC
authors.lastname: Lee
authors.forename: Keun Jung
authors.initials: KJ
authors.lastname: Ryu
authors.forename: Jin Hyun
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D017410:Practice Guidelines as Topic; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D000092464:Elbow Injuries
keywords: Annular ligament; Open reduction and internal fixation; Radial head fractures; Repair