J Orthop Trauma. 2021 Dec 01;35(12):e486-e490. doi: 10.1097/BOT.0000000000002126.
Does Radial Head Resection Impair Hand and Wrist Function? A Long-Term Follow-Up.
Journal of orthopaedic trauma
Erez Avisar, Jonathan Persitz, Noam Shohat, Eran Tamir, Eran Assaraf, Timoret Keren
Affiliations
Affiliations
- Department of Orthopaedic Surgery, Yitzhak Shamir Medical Center, Tzrifin, Israel.
- Hand & Upper Extremity Surgery Unit, Yitzhak Shamir Medical Center, Tzrifin, Israel; and.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
PMID: 33771963
DOI: 10.1097/BOT.0000000000002126
Abstract
OBJECTIVE: To evaluate the long-term outcome in patients after radial head resection surgery for isolated Mason type III radial head fractures.
DESIGN: An observational retrospective case series.
SETTING: A Hand and Upper-Extremity Surgery Unit in a tertiary care center.
PATIENTS: Data were collected from files of patients who were operated between the years 1980 and 2020. Of 352 patients who underwent surgery for radial head fractures, 25 patients were eligible and were enrolled in the study.
INTERVENTION: All participants underwent radial head resection surgery and a follow-up clinical and radiographic evaluation by 2 senior orthopaedic surgeons.
OUTCOME MEASUREMENTS: Objective evaluation included active range of motion of the elbow and wrist joints, ulnohumeral angle, key pinch and grip measurements, and radiographic imaging of elbow and wrist joints. Subjective evaluation included visual analog scale measurements, disability of arm shoulder and hand questionnaire, Mayo wrist score, Michigan hand outcome, and Oxford elbow score.
RESULTS: The mean follow-up was 18 years. Mean elbow range of motion and mean grip strength were lower in the operated hand, as compared to the contralateral hand. Mean proximal radial migration was 1.6 mm. Mean results of visual analog scale, disability of arm shoulder and hand, Mayo wrist score, Michigan hand outcome, and Oxford elbow score indicated good functional outcome and high patient satisfaction.
CONCLUSIONS: In our study population, long-term functional outcomes after radial head resection were encouraging. Thus, this procedure may be considered as a surgical alternative when radial head reconstruction or replacement fails.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Conflict of interest statement
The authors report no conflict of interest.
References
- Beingessner DM, Dunning CE, Gordon KD, et al. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am. 2004;86:1730–1739. - PubMed
- Charalambous CP, Stanley JK, Mills SP, et al. Comminuted radial head fractures: aspects of current management. J Shoulder Elbow Surg. 2011;20:996–1007. - PubMed
- Schneeberger AG, Sadowski MM, Jacob HAC. Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg Am. 2004;86:975–982. - PubMed
- Tejwani SG, Markolf KL, Benhaim P. Graft reconstruction of the interosseous membrane in conjunction with metallic radial head replacement: a cadaveric study. J Hand Surg. 2005;30:335–342. - PubMed
- Duckworth AD, Clement N, Jenkins P, et al. The epidemiology of radial head and neck fractures [Internet]. J Hand Surg. 2012;37:112–119. - PubMed
- Morrey BF, An KN. Stability of the elbow: osseous constraints. J Shoulder Elbow Surg. 2005;14:174S–178S. - PubMed
- Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42:123–132. - PubMed
- Duckworth AD, McQueen MM, Ring D. Fractures of the radial head. Bone Joint J. 2013;95-B:151–159. - PubMed
- Fowler JR, Henry SE, Xu P, et al. Outcomes following radial head arthroplasty. Orthopedics. 2016;39:153–160. - PubMed
- Essex-Lopresti P. Fractures of the radial head with distal radio-ulnar dislocation; report of two cases. J Bone Joint Surg Br. 1951;33B:244–247. - PubMed
- Moro JK, Werier J, MacDermid JC, et al. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83:1201–1211. - PubMed
- Burkhart KJ, Mattyasovszky SG, Runkel M, et al. Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elbow Surg. 2010;19:965–972. - PubMed
- Schiffern A, Bettwieser SP, Porucznik CA, et al. Proximal radial drift following radial head resection. J Shoulder Elbow Surg. 2011;20:426–433. - PubMed
- Tarallo L, Mugnai R, Rocchi M, et al. Mason type III radial head fractures treated by anatomic radial head arthroplasty: is this a safe treatment option?. Orthop Traumatol Surg Res. 2017;103:183–189. - PubMed
- van Riet R, van den Bekerom M, Van Tongel A, et al. Radial head fractures. Shoulder Elbow. 2020;12:212–223. - PubMed
- Eyberg BA, McKee MD. Indications and clinical results of radial head replacement: has anything changed?. J Orthop Trauma. 2019;33:S1–S6. - PubMed
- Coleman DA, Blair WF, Shurr D. Radial head resection for isolated radial head fractures—a long term follow-up. Iowa Orthop J. 1985;5:48–54. - PubMed
- Iftimie PP, Calmet Garcia J, de Loyola Garcia Forcada I, et al. Resection arthroplasty for radial head fractures: long-term follow-up. J Shoulder Elbow Surg. 2011;20:45–50. - PubMed
- Ruchelsman DE, Christoforou D, Jupiter JB. Fractures of the radial head and neck. The journal of bone and joint surgery. J Bone Joint Surg Am. 2013;95:469–478. - PubMed
- Miller G, Humadi A, Unni R, et al. Surgical management of Mason type III radial head fractures. Indian J Orthop. 2013;47:323–332. - PubMed
- Esser RD, Davis S, Taavao T. Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma. 1995;9:318–323. - PubMed
- King GJ, Evans DC, Kellam JF. Open reduction and internal fixation of radial head fractures. J Orthop Trauma. 1991;5:21–28. - PubMed
- Herbertsson P, Josefsson P-O, Hasserius R, et al. Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long-term follow-up study. J Bone Joint Surg Am. 2004;86:569–574. - PubMed
- Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand. 2000;71:191–194. - PubMed
- Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am. 1986;68:669–674. - PubMed
- Fuchs S, Chylarecki C. Do functional deficits result from radial head resection?. J Shoulder Elbow Surg. 1999;8:247–251. - PubMed
- Sanchez-Sotelo J, Romanillos O, Garay EG. Results of acute excision of the radial head in elbow radial head fracture-dislocations. J Orthop Trauma. 2000;14:354–358. - PubMed
- Antuña SA, Sánchez-Márquez JM, Barco R. Long-term results of radial head resection following isolated radial head fractures in patients younger than forty years old. J Bone Joint Surg Am. 2010;92:558–566. - PubMed
- Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am. 2002;84:547–551. - PubMed
- Akman YE, Sukur E, Circi E, et al. A comparison of the open reduction-internal fixation and resection arthroplasty techniques in treatment of Mason Type 3 radial head fractures. Acta Orthop Traumatol Turc. 2017;51:118–122. - PubMed
- Kiechle M, Thannheimer A, Hungerer S, et al. Long-term outcomes after primary radial head resection arthroplasty vs. Acute radial head resection vs. Secondary prosthetic removal in comminuted radial head fractures. Arch Bone Jt Surg. 2019;7:112–117. - PubMed
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