Analysis of the Factors Influencing on the Postoperative Results of Radial Head Fractures Combined with Elbow Dislocation

Ho-Jung Kang; Eun-Su Moon; Jin-Oh Park; Soo-Bong Hahn; Sang-Pil Yoon; Chong-Hyuk Choi

doi:10.4055/jkoa.2007.42.5.599

Journal List > J Korean Orthop Assoc > v.42(5) > 1012703

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Kang, Moon, Park, Hahn, Yoon, and Choi: Analysis of the Factors Influencing on the Postoperative Results of Radial Head Fractures Combined with Elbow Dislocation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(5): 599-607.

Published online: 31 October 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.5.599

Analysis of the Factors Influencing on the Postoperative Results of Radial Head Fractures Combined with Elbow Dislocation

Ho-Jung Kang, M.D., Eun-Su Moon, M.D., Jin-Oh Park, M.D., Soo-Bong Hahn, M.D., Sang-Pil Yoon, M.D., Chong-Hyuk Choi, M.D.

Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Chong-Hyuk Choi, M.D. Department of Orthopedic Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, 612, Eonjuro, Gangnam-gu, Seoul 135-720, Korea. Tel: +82.2-2019-3410, Fax: +82.2-573-5393, choi8422@yumc.yonsei.ac.kr

Abstract

Purpose

Radial head fractures are the most common elbow fractures in adults, and are often accompanied with elbow dislocation resulting in various complications. This study examined the outcome of surgical treatment of a radial head fracture and its prognostic factors.

Materials and Methods

From January 1997 to February 2004, a retrospective analysis was performed on 25 radial head fracture patients with an elbow dislocation, also including elbow fracture, whose follow-up data could be obtained for more than 12 months. The surgical results were evaluated according to the prognostic factors and the Mayo Elbow Performance Index, which assessed the elbow joint function and pain.

Results

According to the Mayo Elbow Performance Index, the results were excellent in 11 cases, good in 5 cases, fair in 5 cases, and poor in 4 cases. Cases with post-surgical elbow joint instability showed statistically meaningful poor outcomes. However, there were good in the groups without an accompanied fracture, with no open fracture, type II and III Mason classification, and fixation period 4 weeks or less. Correlation analysis revealed a younger age and shorter immobilization period to have better results, and the immobilization period showed the strongest correlations with the Mayo Elbow Performance index.

Conclusion

In conclusion, younger age, less severe injury in the initial event and a shorter immobilization period are good prognostic factors in radial head fractures combined elbow dislocations.

Keywords: Elbow dislocation, Radial head fracture, Prognostic factor, Immobilization day, Age

Figures and Tables

Fig. 1

(A) Preoperative radiological findings of a Mason type II radial head fracture with an elbow joint dislocation. (B) Intraoperative photograph shows the internal fixation using a mini screw and K-wire. At the final follow-up, the range of movement ranged from 15 to 120°.

Fig. 2

(A) Pre-operative radiological finding of Mason type III radial head fractures and capitulum fracture involving an elbow joint dislocation. (B) On the post operational finding, prosthetic radial head replacement was performed, and internal fixation using a herbert screw was performed for the capitulum fracture. At the final follow-up, the range of movement ranged from 15 to 120°.

Table 1

Case Demographics

^*Dorminant arm; ^†Associate injury around elbow and forearm; ^‡Open fracture, TD, Trauma day; Tx, Treatment; CR, Closed reduction; OR, Open reduction and internal fixation; E, Excision of radial head; P, Radial head artificial prosthesis; EF, External fixation; Cor Fx, Coronoid fracture, Immo day: mmobilization day; F/U, Follow up; ROM, Range of motion; sup/pro, Supination/pronation; HO, Heterotropic ossification; UNP, Ulnar nerve palsy.

Table 2

Mason Classification (T-test between type 2 and 3)

Table 3

Associated Injury (T-Test)

Table 4

Immobilization Period (T-Test)

Table 5

Correlation Analysis

Pearson's correlation coefficient, N=25. HO: Prob>lrl for testing of Rho=0.

Table 6

Multiple Regression Analysis

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