Clinical Efficacy And Analysis Of Open Reduction And Internal Fixation Plus Radial Head Resection In Treatment Of Radial Head Fractures

ObjectiveTo Analysis prognostic outcome of open reduction and internal fixation with radial head resection in treatment of Mason type III and IV radial head fracture, so as to explore the selection of operation method of complex fractures of the radial head and to provide the reference for clinical.MethodsA retrospective analysis of2008October to2012January in Wuhan Puai hospital,32cases of Mason type III and IV radial head fracture was enrolled in the study, including19males and13females, With the lateral collateral ligament injury in3cases,6cases with medial collateral ligament injury,5cases with fracture of the coronoid process of the ulna olecranon fracture,2cases with fracture of olecranon, humeral condyle fracture in2cases, capitulum humeral fracture in3cases,5cases of humeral head cartilage denudation, pisiform bone fracture in1case,1case with scaphoid fracture; among them,10cases (5cases with Mason type Ⅲ and5cases with Mason type Ⅳ) received radial head resection,and22cases (13cases with Mason type Ⅲ and9cases with Mason type Ⅳ) underwent open reduction and internal fixation, including nail and plate fixation in seven and screw fixation in fifteen, postoperative in Chinese herbal fumigation and washing with the routine guidance for patients with functional exercise.ResultsThe average follow-up time was14.5months (7to23months), All underwent open reduction and internal fixation of fractures were healed, and no internal fixation failure,3patients had postoperative elbow joint myositis ossificans,We had measured the elbow’s rang of motion to assess the recovery of elbow’s function; took the Mayo elbow performance score system to score the elbow’s capability; and adopted the visual analogue score to appraise the patient’s feeling conditional.1.the open reduction and internal fixation group and radial head resection group of flexion-extension extent was respectively124°and66.9°, rotating arc was150°and105°(P<0.01), there is great statistically significance.2. score according to Mayo elbow function, the excellent and good rate of the open reduction and internal fixation group was86%, the radial head resection group was50%,(P<0.05), there is great statistically significance.3. the open reduction and internal fixation group with the radial head resection group in the excellent and good rate of VAS was77%and30%respectively (P<0.05). there is great statistically significance too.ConclusionOpen reduction and internal fixation can obtain better elbow joint function and higher quality of life than radial head resection in the treatment of Mason III or IV radial head fractures, The radial head has important physiological function,as long as the technical conditions are ripe and permitted, we should try our best to repair and reconstruction of the radial head. Radial head excision has more long-term complications, such as instability of elbow joint, osteoarthritis of elbow and wrist joint, and distal radioulnar joint and semiluxition as well, so we should chose it in cautions, in other words, it should not be the first choice. Chinese herbal fumigation has positive clinical effects in easing pain and promoting functional recovery, It is worthy for clinical application.