Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures
Purpose. To compare the outcome following headless compression screw fixation versus radial head arthroplasty versus plate fixation for 3-part Mason types III or IV radial head fracture. Methods. Records of 25 men and 16 women aged 21 to 80 (mean, 43.3) years who underwent fixation using 2 to 3 2-mm...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2016-04-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/230949901602400114 |
| _version_ | 1818136736646037504 |
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| author | Pang Hung Wu Liang Shen Yu Han Chee |
| author_facet | Pang Hung Wu Liang Shen Yu Han Chee |
| author_sort | Pang Hung Wu |
| collection | DOAJ |
| description | Purpose. To compare the outcome following headless compression screw fixation versus radial head arthroplasty versus plate fixation for 3-part Mason types III or IV radial head fracture. Methods. Records of 25 men and 16 women aged 21 to 80 (mean, 43.3) years who underwent fixation using 2 to 3 2-mm cannulated headless compression screws (n=16), radial head arthroplasty (n=13), or fixation with a 2-mm Synthes plate (n=12) for 3-part Mason types III or IV radial head and neck fracture were reviewed. Treatment option was decided by the surgeon based on the presence of associated injury, neurovascular deficit, and the Mason classification. Bone union, callus formation, and complications (such as heterotopic ossification, malunion, and nonunion) were assessed by an independent registrar or consultant using radiographs. The Mayo Elbow Performance Score and range of motion were assessed by an independent physiotherapist. Results. The median age of the 3 groups were comparable. Associated injuries were most common in patients with arthroplasty, followed by screw fixation and plate fixation (61.5% vs. 50% vs. 33%, p=0.54). The median time to bone union was shorter after screw fixation than plate fixation (55 vs. 86 days, p=0.05). No patient with screw fixation had nonunion, but 4 patients with plate fixation had nonunion. The 3 groups were comparable in terms of the mean Mayo Elbow Performance Score (p=0.56) and the mean range of motion (p=0.45). The complication rate was highest after plate fixation, followed by screw fixation and arthroplasty (50% vs. 18.8% vs. 15.4%, p=0.048). Excluding 20 patients with associated injuries (8 in screw fixation, 8 in arthroplasty, and 4 in plate fixation), the 3 groups were comparable in terms of the median time to bone union (p=0.109), mean Mayo Elbow Performance Score (p=0.260), mean range of motion (p=0.162), and complication rate (p=0.096). Conclusion. Headless compression screw fixation is a viable option for 3-part radial head fracture. It achieves earlier bone union with fewer complications. |
| first_indexed | 2024-12-11T09:45:09Z |
| format | Article |
| id | doaj.art-000d0c1de04a4202845e4be72810382b |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-11T09:45:09Z |
| publishDate | 2016-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-000d0c1de04a4202845e4be72810382b2022-12-22T01:12:35ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902016-04-012410.1177/230949901602400114Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head FracturesPang Hung Wu0Liang Shen1Yu Han Chee2 Department of Orthopaedic Surgery, National University Hospital Systems, Singapore Department of Biostatistics, National University Singapore, Singapore Department of Orthopaedic Surgery, National University Hospital Systems, SingaporePurpose. To compare the outcome following headless compression screw fixation versus radial head arthroplasty versus plate fixation for 3-part Mason types III or IV radial head fracture. Methods. Records of 25 men and 16 women aged 21 to 80 (mean, 43.3) years who underwent fixation using 2 to 3 2-mm cannulated headless compression screws (n=16), radial head arthroplasty (n=13), or fixation with a 2-mm Synthes plate (n=12) for 3-part Mason types III or IV radial head and neck fracture were reviewed. Treatment option was decided by the surgeon based on the presence of associated injury, neurovascular deficit, and the Mason classification. Bone union, callus formation, and complications (such as heterotopic ossification, malunion, and nonunion) were assessed by an independent registrar or consultant using radiographs. The Mayo Elbow Performance Score and range of motion were assessed by an independent physiotherapist. Results. The median age of the 3 groups were comparable. Associated injuries were most common in patients with arthroplasty, followed by screw fixation and plate fixation (61.5% vs. 50% vs. 33%, p=0.54). The median time to bone union was shorter after screw fixation than plate fixation (55 vs. 86 days, p=0.05). No patient with screw fixation had nonunion, but 4 patients with plate fixation had nonunion. The 3 groups were comparable in terms of the mean Mayo Elbow Performance Score (p=0.56) and the mean range of motion (p=0.45). The complication rate was highest after plate fixation, followed by screw fixation and arthroplasty (50% vs. 18.8% vs. 15.4%, p=0.048). Excluding 20 patients with associated injuries (8 in screw fixation, 8 in arthroplasty, and 4 in plate fixation), the 3 groups were comparable in terms of the median time to bone union (p=0.109), mean Mayo Elbow Performance Score (p=0.260), mean range of motion (p=0.162), and complication rate (p=0.096). Conclusion. Headless compression screw fixation is a viable option for 3-part radial head fracture. It achieves earlier bone union with fewer complications.https://doi.org/10.1177/230949901602400114 |
| spellingShingle | Pang Hung Wu Liang Shen Yu Han Chee Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures Journal of Orthopaedic Surgery |
| title | Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures |
| title_full | Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures |
| title_fullStr | Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures |
| title_full_unstemmed | Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures |
| title_short | Screw Fixation versus Arthroplasty versus Plate Fixation for 3-Part Radial Head Fractures |
| title_sort | screw fixation versus arthroplasty versus plate fixation for 3 part radial head fractures |
| url | https://doi.org/10.1177/230949901602400114 |
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