[Arthroscopic poking reduction and internal fixation of radial head fractures].

OBJECTIVE

To investigate the methods and effectiveness of arthroscopic poking reduction and percutaneous fixation of radial head fractures.

METHODS

Between August 2002 and May 2010, 15 patients with radial head fractures were treated using arthroscopic poking reduction and percutaneous fixation with a Kirschner wire. There were 11 males and 4 females with an average age of 29.6 years (range, 17-41 years). The locations were left side in 6 cases and right side in 9 cases. Injuries were caused by falling in 8 cases, by traffic accident in 4 cases, and by sports in 3 cases. The average time from injury to admission was 3.4 days (range, 1-8 days). Of them, 13 patients had Mason type II, and 2 patients had type III fractures. Accompanying injuries were lateral collateral ligament ruptures in 5 patients.

RESULTS

The X-ray films confirmed good reduction and fracture healing. Incisions healed by first intention; no complication occurred, such as neurovascular injury, infection, or hardware failure. All patients were followed up 25 months on average (range, 12-32 months). The flexion-extension arc was (139.0 +/- 7.9) degrees at last follow-up, showing no significant difference when compared with the contralateral (141.0 +/- 5.1) degrees (t = 1.146, P = 0.271); the range of pronation and supination was (143.3 +/- 7.0) degrees when compared with the contralateral (146.0 +/- 4.7) degrees (t = -1.948, P = 0.072). The mean Mayo elbow performance score was 92 (range, 80-100); the mean Broberg-Morrey score was 95.2 (range, 85-100); the results were excellent in 12 cases and good in 3 cases.

CONCLUSION

Arthroscopic poking reduction and percutaneous fixation with a Kirschner wire offers accurate reduction, reliable fixation, minimal trauma, rapid recovery, and lower morbidity for Mason type II and selective Mason type III radial head fractures.