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Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty

BACKGROUND: The treatment of modified Mason Type III or IV fractures is controversial. Many authors report open reduction and internal fixation (ORIF) with reconstruction of the radial head, but others advocate radial head arthroplasty (RHA). This study compares the clinical and radiological outcome...

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Autores principales: Ryu, Seung Min, Park, Sam-Guk, Kim, Ji-Hoon, Yang, Han Seok, Na, Ho Dong, Seo, Jae-Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241053/
https://www.ncbi.nlm.nih.gov/pubmed/30532298
http://dx.doi.org/10.4103/ortho.IJOrtho_537_16
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author Ryu, Seung Min
Park, Sam-Guk
Kim, Ji-Hoon
Yang, Han Seok
Na, Ho Dong
Seo, Jae-Sung
author_facet Ryu, Seung Min
Park, Sam-Guk
Kim, Ji-Hoon
Yang, Han Seok
Na, Ho Dong
Seo, Jae-Sung
author_sort Ryu, Seung Min
collection PubMed
description BACKGROUND: The treatment of modified Mason Type III or IV fractures is controversial. Many authors report open reduction and internal fixation (ORIF) with reconstruction of the radial head, but others advocate radial head arthroplasty (RHA). This study compares the clinical and radiological outcomes of ORIF and RHA in modified Mason Type III or IV radial head fracture and evaluates correlations between prognostic factors and postoperative clinical outcomes. MATERIALS AND METHODS: 42 patients with modified Mason Type III or IV radial head fractures who were surgically treated between January 2010 and January 2014 were retrospectively analyzed (20 patients with RHA and 22 patients with ORIF group were selected). Clinically, the patient rated elbow evaluation (PREE), the disabilities of the arm, shoulder and hand (DASH), and the range of motion (ROM) were measured. Radiologically, plain radiographs and computed tomography scans were taken. RESULTS: The mean PREE scores were 13.9 for the RHA group and 13.0 for the ORIF group, and mean DASH scores were 9.5 and 10.7, respectively. The differences were not statistically significant. When comparing ROM, the patients in the RHA group showed greater movement at all measured angles. In multiple regression analysis, age was the only variable significantly associated with both PREE and DASH. CONCLUSION: Overall, there were no significant differences in clinical outcomes of modified Mason Type III or IV radial head fractures treated with ORIF or RHA. However, a subgroup of younger patients had better clinical outcomes with ORIF treatment. Therefore, ORIF should be the First line of treatment, particularly if the reduction is possible.
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spelling pubmed-62410532018-12-10 Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty Ryu, Seung Min Park, Sam-Guk Kim, Ji-Hoon Yang, Han Seok Na, Ho Dong Seo, Jae-Sung Indian J Orthop Original Article BACKGROUND: The treatment of modified Mason Type III or IV fractures is controversial. Many authors report open reduction and internal fixation (ORIF) with reconstruction of the radial head, but others advocate radial head arthroplasty (RHA). This study compares the clinical and radiological outcomes of ORIF and RHA in modified Mason Type III or IV radial head fracture and evaluates correlations between prognostic factors and postoperative clinical outcomes. MATERIALS AND METHODS: 42 patients with modified Mason Type III or IV radial head fractures who were surgically treated between January 2010 and January 2014 were retrospectively analyzed (20 patients with RHA and 22 patients with ORIF group were selected). Clinically, the patient rated elbow evaluation (PREE), the disabilities of the arm, shoulder and hand (DASH), and the range of motion (ROM) were measured. Radiologically, plain radiographs and computed tomography scans were taken. RESULTS: The mean PREE scores were 13.9 for the RHA group and 13.0 for the ORIF group, and mean DASH scores were 9.5 and 10.7, respectively. The differences were not statistically significant. When comparing ROM, the patients in the RHA group showed greater movement at all measured angles. In multiple regression analysis, age was the only variable significantly associated with both PREE and DASH. CONCLUSION: Overall, there were no significant differences in clinical outcomes of modified Mason Type III or IV radial head fractures treated with ORIF or RHA. However, a subgroup of younger patients had better clinical outcomes with ORIF treatment. Therefore, ORIF should be the First line of treatment, particularly if the reduction is possible. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6241053/ /pubmed/30532298 http://dx.doi.org/10.4103/ortho.IJOrtho_537_16 Text en Copyright: © 2018 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Ryu, Seung Min
Park, Sam-Guk
Kim, Ji-Hoon
Yang, Han Seok
Na, Ho Dong
Seo, Jae-Sung
Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title_full Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title_fullStr Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title_full_unstemmed Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title_short Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty
title_sort treatment of modified mason type iii or iv radial head fracture: open reduction and internal fixation versus arthroplasty
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241053/
https://www.ncbi.nlm.nih.gov/pubmed/30532298
http://dx.doi.org/10.4103/ortho.IJOrtho_537_16
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