ARTHROSCOPIC POKING REDUCTION AND INTERNAL FIXATION OF RADIAL HEAD_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SWANG Junliang , LIU Yujie , LI Zhongli , WANG Zhigang , WEI Min.

Department of Orthopaedics, General Hospital of Chinese PLA, Beijing,100853, P.R.China.;

Corresponding author：

Keywords：

Arthroscopy; Elbow joint; Radial head fracture; Reduction and fixation

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【Abstract】 Objective To investigate the methods and effectiveness of arthroscopic poking reduction and percutaneous
fixation of radial head fractures. Methods Between August 2002 and May 2010, 15 patients with radial head fractures were
treated using arthroscopic poking reduction and percutaneous fixation with a Kirschner wire. There were 11 males and 4 females with an average age of 29.6 years (range, 17-41 years). The locations were left side in 6 cases and right side in 9 cases. Injuries were caused by falling in 8 cases, by traffic accident in 4 cases, and by sports in 3 cases. The average time from injury to admission was 3.4 days (range, 1-8 days). Of them, 13 patients had Mason type II, and 2 patients had type III fractures. Accompanying injuries were lateral collateral ligament ruptures in 5 patients. Results The X-ray films confirmed good reduction and fracture heal ing. Incisions healed by first intention; no complication occurred, such as neurovascular injury, infection, or hardware failure. All patients were followed up 25 months on average (range, 12-32 months). The flexion-extension arc was (139.0 ± 7.9)° at last follow-up, showing no significant difference when compared with the contralateral (141.0 ± 5.1)° (t=1.146, P=0.271); the range of pronation and supination was (143.3 ± 7.0)° when compared with the contralateral (146.0 ± 4.7)° (t=1.948, P=0.072). The mean Mayo elbow performance score was 92 (range, 80-100); the mean Broberg-Morrey score was 95.2 (range, 85-100); the results were excellent in 12 cases and good in 3 cases. Conclusion Arthroscopic poking reduction and percutaneous fixation with a Kirschner wire offers accurate reduction, rel iable fixation, minimal trauma, rapid recovery, and lower morbidity for Mason type II and selective Mason type III radial head fractures.

Citation： SWANG Junliang ,LIU Yujie,LI Zhongli,WANG Zhigang,WEI Min.. ARTHROSCOPIC POKING REDUCTION AND INTERNAL FIXATION OF RADIAL HEAD. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(2): 208-211. doi: Copy

1.	Dodson C, Nho S, Williams RJ 3rd, et al. Elbow arthroscopy. J Am Acad Orthop Surg, 2008, 16(10): 574-585.
2.	Haddad N, Chebil M, Mili W, et al. Technique and indications of elbow arthroscopy. A twelve-cases report. Tunis Med, 2009, 87(2): 120-122.
3.	Michels F, Pouliart N, Handelberg F. Arthroscopic management of Mason type 2 radial head fractures. Knee Surg Sports Traumatol Arthrosc, 2007, 15(10): 1244-1250.
4.	Rolla PR, Surace MF, Bini A, et al. Arthroscopic treatment of fractures of the radial head. Arthroscopy, 2006, 22(2): 233. e1-233. e6.
5.	Atesok K, Doral MN, Whipple T, et al. Arthroscopy-assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 320-329.
6.	刘碧峰, 林志金, 曹烈虎, 等. 切开复位内固定与桡骨小头假体置换治疗Mason Ⅲ型桡骨小头骨折疗效比较. 中国修复重建外科杂志, 2010, 24(8): 900-903.
7.	Ikeda M, K Sugiyama, Kang C, et al. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg (Am), 2005, 87(1): 76-84.
8.	王道喜, 唐学阳, 蒋欣, 等. 小儿MasonⅡ型桡骨头颈部骨折的修复. 中国修复重建外科杂志, 2010, 24(4): 435-437.
9.	Ertürer E, Seçkin F, Akman S, et al. The results of open reduction and screw or K-wire fixation for isolated type II radial head fractures. Acta Orthop Traumatol Turc, 2010, 44(1): 20-26.
10.	Burkhart KJ, Nowak TE, Appelmann P, et al. Screw fixation of radial head fractures: compression screw versus lag screw—a biomechanical comparison. Injury, 2010, 41(10): 1015-1019.
11.	Ozkan Y, Oztürk A, Ozdemir RM, et al. Open reduction and internal fixation of radial head fractures. Ulus Travma Acil Cerrahi Derg, 2009, 15(3): 249-255.
12.	张英泽, 郭明珂, 郑占乐, 等. 桡骨头颈骨折治疗方法的选择与疗效观察. 中华外科杂志, 2009, 47(12): 896-898.
13.	Nalbantoglu U, Kocaoglu B, Gereli A, et al. Open reduction and internal fixation of Mason type III radial head fractures with and without an associated elbow dislocation. J Hand Surg(Am), 2007, 32(10): 1560-1568.
14.	Businger A, Ruedi TP, Sommer C. On-table reconstruction of comminuted fractures of the radial head. Injury, 2010, 41(6): 583-588.
15.	Müller MC, Burger C, Wirtz DC, et al. Replacement of the comminuted radial head fracture by a bipolar radial head prosthesis. Oper Orthop Traumatol, 2011, 23(1): 37-45.
16.	Chebil M, Kanoun ML, Ben Maitigue M, et al. Fracture of the radial head: the role of excision. Tunis Med, 2007, 85(2): 116-120.
17.	Kaas L, Turkenburg JL, van Riet RP, et al. Magnetic resonance imaging findings in 46 elbows with a radial head fracture. Acta Orthop, 2010, 81(3): 373-376.
18.	Kaas L, van Riet RP, Vroemen JP, et al. The incidence of associated fractures of the upper limb in fractures of the radial head. Strategies Trauma Limb Reconstr, 2008, 3(2): 71-74.
19.	Itamura J, Roidis N, Mirzayan R, et al. Radial head fractures: MRI evaluation of associated injuries. J Shoulder Elbow Surg, 2005, 14(4): 421-424.

1. Dodson C, Nho S, Williams RJ 3rd, et al. Elbow arthroscopy. J Am Acad Orthop Surg, 2008, 16(10): 574-585.
2. Haddad N, Chebil M, Mili W, et al. Technique and indications of elbow arthroscopy. A twelve-cases report. Tunis Med, 2009, 87(2): 120-122.
3. Michels F, Pouliart N, Handelberg F. Arthroscopic management of Mason type 2 radial head fractures. Knee Surg Sports Traumatol Arthrosc, 2007, 15(10): 1244-1250.
4. Rolla PR, Surace MF, Bini A, et al. Arthroscopic treatment of fractures of the radial head. Arthroscopy, 2006, 22(2): 233. e1-233. e6.
5. Atesok K, Doral MN, Whipple T, et al. Arthroscopy-assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 320-329.
6. 刘碧峰, 林志金, 曹烈虎, 等. 切开复位内固定与桡骨小头假体置换治疗Mason Ⅲ型桡骨小头骨折疗效比较. 中国修复重建外科杂志, 2010, 24(8): 900-903.
7. Ikeda M, K Sugiyama, Kang C, et al. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg (Am), 2005, 87(1): 76-84.
8. 王道喜, 唐学阳, 蒋欣, 等. 小儿MasonⅡ型桡骨头颈部骨折的修复. 中国修复重建外科杂志, 2010, 24(4): 435-437.
9. Ertürer E, Seçkin F, Akman S, et al. The results of open reduction and screw or K-wire fixation for isolated type II radial head fractures. Acta Orthop Traumatol Turc, 2010, 44(1): 20-26.
10. Burkhart KJ, Nowak TE, Appelmann P, et al. Screw fixation of radial head fractures: compression screw versus lag screw—a biomechanical comparison. Injury, 2010, 41(10): 1015-1019.
11. Ozkan Y, Oztürk A, Ozdemir RM, et al. Open reduction and internal fixation of radial head fractures. Ulus Travma Acil Cerrahi Derg, 2009, 15(3): 249-255.
12. 张英泽, 郭明珂, 郑占乐, 等. 桡骨头颈骨折治疗方法的选择与疗效观察. 中华外科杂志, 2009, 47(12): 896-898.
13. Nalbantoglu U, Kocaoglu B, Gereli A, et al. Open reduction and internal fixation of Mason type III radial head fractures with and without an associated elbow dislocation. J Hand Surg(Am), 2007, 32(10): 1560-1568.
14. Businger A, Ruedi TP, Sommer C. On-table reconstruction of comminuted fractures of the radial head. Injury, 2010, 41(6): 583-588.
15. Müller MC, Burger C, Wirtz DC, et al. Replacement of the comminuted radial head fracture by a bipolar radial head prosthesis. Oper Orthop Traumatol, 2011, 23(1): 37-45.
16. Chebil M, Kanoun ML, Ben Maitigue M, et al. Fracture of the radial head: the role of excision. Tunis Med, 2007, 85(2): 116-120.
17. Kaas L, Turkenburg JL, van Riet RP, et al. Magnetic resonance imaging findings in 46 elbows with a radial head fracture. Acta Orthop, 2010, 81(3): 373-376.
18. Kaas L, van Riet RP, Vroemen JP, et al. The incidence of associated fractures of the upper limb in fractures of the radial head. Strategies Trauma Limb Reconstr, 2008, 3(2): 71-74.
19. Itamura J, Roidis N, Mirzayan R, et al. Radial head fractures: MRI evaluation of associated injuries. J Shoulder Elbow Surg, 2005, 14(4): 421-424.

Chinese Journal of Reparative and Reconstructive Surgery

ARTHROSCOPIC POKING REDUCTION AND INTERNAL FIXATION OF RADIAL HEAD

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