Arthroscopic surgery for radial head fractures: A prospective series of 9 cases - 13/11/14
Chirurgie des fractures de la tête radiale sous arthroscopie : à propos de 9 cas
Résumé |
Introduction |
The main complication of radial head fracture is elbow stiffness consequence of ligament injuries due to the trauma and those due to the surgery The aim of this study is to use an arthroscopic procedure for reduction and internal fixation:
– enabling a complete diagnosis of ligament impairments (medial, volar, lateral);
– sparing the collateral lateral and annular ligaments during the reduction and fixation.
Materials and methods |
Over a 2-year period, 9 displaced fractures were operated with arthroscopy. We only retained recent Mason 2 & 3 fractures without dislocation. We used 3 portals, percutaneous cannulated screws, an antalgic splint for 3weeks and an immediate active & passive physiotherapy. Physical examination and X-ray were done after 3, 6 and 12weeks. Analysis criteria were:
– perioperative: ligament impairment, time of surgery;
– postoperative: motion, grasp strength, time without working and sports, X-ray analysis (reduction, consolidation, secondary displacement).
Results |
Time of surgery went down from 90 to 40minutes; annular ligament was initially intact in 7/9 cases. Active range of motion was:
– 3weeks: F/E 90°, P/S 150°;
– 6weeks: F/E 110°, P/S 160°;
– 12weeks: F/E 120°, P/S 160°.
We noticed 7 anatomic reductions (all Mason 2) and no secondary displacement.
Time without working was 3weeks (0–12).
Discussion and conclusion |
Active motion was almost fully recovered after 6weeks. The absence of secondary displacement suggests benefits of harder initial rehabilitation. Range of motion is at the minimum the same as other studies with shorter convalescence. None second time surgery was needed. Arthroscopic surgery for radial head fracture is a reliable and efficient procedure enabling rapid working and sports recovery.
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Vol 100 - N° 8S
P. e8 - décembre 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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