Universität zu Köln

Hackl, Michael ORCID: 0000-0002-6183-5621, Wegmann, Kilian, Hollinger, Boris, El-Zayat, Bilal F., Seybold, Dominik, Guehring, Thorsten, Schnetzke, Marc, Schmidt-Horlohe, Kay, Greiner, Stefan, Lill, Helmut, Ellwein, Alexander, Glanzmann, Michael C., Siebenlist, Sebastian, Jaeger, Martin, Weber, Joerg and Mueller, Lars P. (2019). Surgical revision of radial head fractures: a multicenter retrospective analysis of 466 cases. J. Shoulder Elbow Surg., 28 (8). S. 1457 - 1468. NEW YORK: MOSBY-ELSEVIER. ISSN 1058-2746

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Abstract

Background<bold>: </bold>Radial head fractures lead to persisting disability in a considerable number of cases. This study aimed to investigate their most common revision causes and procedures. <bold> </bold>Methods: This multicenter retrospective study reviewed the cases of 466 adult patients who had undergone surgical revision after operative or nonoperative treatment of a radial head fracture. The initial diagnosis was a Mason type I fracture in 13.0%, Mason type II fracture in 14.6%, Mason type III fracture in 22.8%, Mason type IV fracture in 20.9%, terrible-triad injury in 12.8%, Monteggia-like lesion in 13.1%, and Essex-Lopresti lesion in 2.0%. Initial treatment was nonoperative in 30.2%, open reduction and internal fixation (ORIF) in 44.9%, radial head arthroplasty in 16.6%, radial head resection in 3.7%, sole treatment of concomitant injuries in 2.6%, and fragment excision in 2.0%. Up to 3 revision causes and procedures were recorded per case. <bold> </bold>Results: The most common complications were stiffness (67.4%), instability (36.5%), painful osteoarthritis (29.2%), ORIF related (14.8%), nonunion or necrosis (9.2%), radial head arthroplasty related (7.5%), ulnar neuropathy (6.0%), and infection (2.6%). Revision procedures frequently included arthrolysis (42.1%), arthroplasty (24.9%), implant removal (23.6%), ligament repair or reconstruction (23.0%), debridement (14.2%), repeated ORIF (8.2%), and/or radial head resection (7.7%). Mason type I or II fractures were primarily revised because of stiffness and painful osteoarthritis. Complications after Mason type III fractures were predominantly ORIF related. Fracture-dislocations showed a wide range of complications, with instability and stiffness comprising the most common causes of revision. <bold> </bold>Conclusions: The complications of radial head fractures are characteristic to their classification. Knowledge of these findings might guide surgeons in treating these injuries and may help counsel patients accordingly. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hollinger, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED El-Zayat, Bilal F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seybold, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Guehring, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnetzke, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt-Horlohe, Kay UNSPECIFIED UNSPECIFIED UNSPECIFIED Greiner, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lill, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Ellwein, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Glanzmann, Michael C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebenlist, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaeger, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134092
DOI:	10.1016/j.jse.2018.11.047
Journal or Publication Title:	J. Shoulder Elbow Surg.
Volume:	28
Number:	8
Page Range:	S. 1457 - 1468
Date:	2019
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1058-2746
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TERRIBLE TRIAD; LIGAMENT RECONSTRUCTION; INTERNAL-FIXATION; VALGUS STABILITY; OPEN REDUCTION; ELBOW; REPLACEMENT; INJURIES; RADIOCAPITELLAR; COMPLICATIONS Multiple languages Orthopedics; Sport Sciences; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13409