J Korean Orthop Assoc.  2007 Oct;42(5):599-607. 10.4055/jkoa.2007.42.5.599.

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

• Kang HJ
• Moon ES
• Park JO
• Hahn SB
• Yoon SP
• Choi CH

• KMID: 2186466
• DOI: http://doi.org/10.4055/jkoa.2007.42.5.599

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.

Keyword

Elbow dislocation; Radial head fracture; Prognostic factor; Immobilization day; Age

MeSH Terms

Adult
Classification
Dislocations*
Elbow Joint
Elbow*
Follow-Up Studies
Fractures, Open
Head*
Humans
Immobilization
Retrospective Studies

Figure

• 

  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°.

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