Cargando…
Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures
BACKGROUND: The use of bone graft for the radial head fractures has been previously described and occasionally used by other authors.This is the first paper, to my knowledge, dealing with the relevant issue about the importance that the use of an autologous bone graft can have on the radial head fra...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094563/ https://www.ncbi.nlm.nih.gov/pubmed/30111311 http://dx.doi.org/10.1186/s12891-018-2214-4 |
_version_ | 1783347843483828224 |
---|---|
author | Liu, Guanyi Chen, Erman Xu, Dingli Ma, Weihu Zhou, Leijie Chen, Jianming Pan, Zhijun |
author_facet | Liu, Guanyi Chen, Erman Xu, Dingli Ma, Weihu Zhou, Leijie Chen, Jianming Pan, Zhijun |
author_sort | Liu, Guanyi |
collection | PubMed |
description | BACKGROUND: The use of bone graft for the radial head fractures has been previously described and occasionally used by other authors.This is the first paper, to my knowledge, dealing with the relevant issue about the importance that the use of an autologous bone graft can have on the radial head fractures. METHODS: From July 2010 to July 2014, 20 consecutive patients who underwent open reduction and internal fixation for a closed Mason type II radial head fracture were retrospectively reviewed. Patients with Mason type I, III, simple type II, and comminuted type II fractures treated without bone grafting were excluded. A clinical examination and radiographic evaluation were performed. The overall functional result was evaluated using the Mayo Elbow Performance Score (MEPS). The Broberg and Morrey classification was used to evaluate traumatic arthritis. RESULTS: The average follow-up duration was 31 months (range, 24–50 months). Bone union of the radial head fracture was achieved in all patients at an average of 13.5 weeks (range, 12–17 weeks). Postoperative radiographs showed no cases of postsurgical ligamentous instability, necrosis of the radial head, or internal fixation failure. The mean range of motion of the affected elbow was 128° ± 8.4° in flexion, 14.5° ± 11.1° in extension, 68.7° ± 14.1° in pronation, and 65.2° ± 18.2° in supination. The mean MEPS was 92 ± 7.9 points (range, 80–100); the outcome was excellent (90–100 points) in 13 patients and good (75–89 points) in 7 patients. The MEPS tended to be higher in patients with an isolated fracture (p = 0.016). Based on the Broberg and Morrey classification for radiographic assessment of post-traumatic arthritis, 15 elbows had no evidence of degenerative changes (grade 0), and 5 elbows had grade 1 changes. CONCLUSION: Although radial head fractures may not be amenable to internal fixation, our findings suggest that open reduction and internal fixation with an autogenous bone graft from the lateral epicondyle of the humerus provides satisfactory elbow function in patients with comminuted Mason type II radial head fractures. |
format | Online Article Text |
id | pubmed-6094563 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60945632018-08-24 Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures Liu, Guanyi Chen, Erman Xu, Dingli Ma, Weihu Zhou, Leijie Chen, Jianming Pan, Zhijun BMC Musculoskelet Disord Technical Advance BACKGROUND: The use of bone graft for the radial head fractures has been previously described and occasionally used by other authors.This is the first paper, to my knowledge, dealing with the relevant issue about the importance that the use of an autologous bone graft can have on the radial head fractures. METHODS: From July 2010 to July 2014, 20 consecutive patients who underwent open reduction and internal fixation for a closed Mason type II radial head fracture were retrospectively reviewed. Patients with Mason type I, III, simple type II, and comminuted type II fractures treated without bone grafting were excluded. A clinical examination and radiographic evaluation were performed. The overall functional result was evaluated using the Mayo Elbow Performance Score (MEPS). The Broberg and Morrey classification was used to evaluate traumatic arthritis. RESULTS: The average follow-up duration was 31 months (range, 24–50 months). Bone union of the radial head fracture was achieved in all patients at an average of 13.5 weeks (range, 12–17 weeks). Postoperative radiographs showed no cases of postsurgical ligamentous instability, necrosis of the radial head, or internal fixation failure. The mean range of motion of the affected elbow was 128° ± 8.4° in flexion, 14.5° ± 11.1° in extension, 68.7° ± 14.1° in pronation, and 65.2° ± 18.2° in supination. The mean MEPS was 92 ± 7.9 points (range, 80–100); the outcome was excellent (90–100 points) in 13 patients and good (75–89 points) in 7 patients. The MEPS tended to be higher in patients with an isolated fracture (p = 0.016). Based on the Broberg and Morrey classification for radiographic assessment of post-traumatic arthritis, 15 elbows had no evidence of degenerative changes (grade 0), and 5 elbows had grade 1 changes. CONCLUSION: Although radial head fractures may not be amenable to internal fixation, our findings suggest that open reduction and internal fixation with an autogenous bone graft from the lateral epicondyle of the humerus provides satisfactory elbow function in patients with comminuted Mason type II radial head fractures. BioMed Central 2018-08-16 /pmc/articles/PMC6094563/ /pubmed/30111311 http://dx.doi.org/10.1186/s12891-018-2214-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Technical Advance Liu, Guanyi Chen, Erman Xu, Dingli Ma, Weihu Zhou, Leijie Chen, Jianming Pan, Zhijun Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title | Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title_full | Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title_fullStr | Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title_full_unstemmed | Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title_short | Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures |
title_sort | open reduction and internal fixation with bone grafts for comminuted mason type ii radial head fractures |
topic | Technical Advance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094563/ https://www.ncbi.nlm.nih.gov/pubmed/30111311 http://dx.doi.org/10.1186/s12891-018-2214-4 |
work_keys_str_mv | AT liuguanyi openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT chenerman openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT xudingli openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT maweihu openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT zhouleijie openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT chenjianming openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures AT panzhijun openreductionandinternalfixationwithbonegraftsforcomminutedmasontypeiiradialheadfractures |