| Objective:The common surgical approach for radial head fracture is the lateral approach.It has been reported that this approach increasing the risk of iatrogenic injury to the deep branch of the radial nerve and the Lateral Ulnar Collateral Ligament.Furthermore,the lateral approach cannot completely expose the anteromedial aspect of the radial head.With anterior approach incision,the case of radial head fracture combining coronoid process fracture can be treated at the same time.This paper aims to make a retrospective study and analysis on the treatment of radial head fracture by anterior elbow approach and lateral elbow approach,and compare the clinical outcomes of the two surgical approaches in the treatment of radial head fracture.Materials and Methods:During January 2017 to June 2019,22 patients with radial head fracture treated with open reduction and internal fixation with plate were considered for inclusion in the study.The anterior approach group included 11 individuals,these were 7 males and 4 females,aged from 23 to 64 years,with an average of(40.82 ±14.12)years.One of them was combined with coronoid process fracture,and the fracture was classified as Regan-MorreyⅠ.The lateral approach group included 11 individuals,these were 6 males and 5 females,aged from 23 to 55 years,with an average age of(38.82±9.93)years.After preoperative preparation,the two groups underwent open reduction and internal fixation in differentsurgical approaches.The perioperative and postoperative follow-up data of the patients and the postoperative elbow joint activity were recorded in detail.The elbow joint function was evaluated by Broberg and Morrey elbow joint function scoring system.The follow-up data of all patients were processed and analyzed by SPSS 23.0(IBM company)statistical software.Result:All patients were followed up for an average of 18 months.There exhibited no complications,such as incision infection,nerve injury,loosening of internal fixation,nonunion or malunion of fracture in the two groups.The operation time of the anterior approach group was shorter than the lateral approach group,and the incision length of the anterior approach group was longer than the lateral approach group.Difference between the two groups has statistical significance(P < 0.05).There was no statistically significant difference in flexion range of motion,pronation,supination and Broberg and Morrey elbow function score between the two groups at the last follow-up.There was statistically significant difference in the range of elbow extension between the two groups(P < 0.05).Conclusion:When the radial head fracture is located in the anterior or medial side,or when the radial head fracture is combined with coronal process fracture,it is recommended to choose the anterior approach,which canshorten the operation time and minimize the damage to the soft tissues.For simple radial head fracture,there are no statistical significance difference in terms of postoperative functional score between the two approaches,and operators can choose approaches according to their own proficiency. |
