Guerra Enrico, Marinelli Alessandro, Tortorella Fabio, Flöter Michelle Dos Santos, Ritali Alice, Sessa Andrea, Carbone Giuseppe, Cavallo Marco
Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Orthopedics and Traumatology Department, Kantonsspital St. Gallen, 9000 St. Gallen, Switzerland.
J Clin Med. 2023 Feb 16;12(4):1558. doi: 10.3390/jcm12041558.
This study aimed to describe the ARIF (Arthroscopic Reduction Internal Fixation) technique for radial head fractures and to compare the results with ORIF (Open Reduction Internal Fixation) at mean 10 years.
A total of 32 patients affected by Mason II or III fractures of the radial head who underwent ARIF or ORIF by screws fixation were retrospectively selected and evaluated. A total of 13 patients were treated (40.6%) by ARIF and 19 patients (59.4%) by ORIF. Mean follow-up was 10 years (7-15 years). All patients underwent MEPI and BMRS scores at follow-up, and statistical analysis was performed.
No statistical significance was reported in Surgical Time ( = 0.805) or BMRS ( = 0.181) values. Significative improvement was recorded in MEPI score ( = 0.036), and between ARIF (98.07, SD ± 4.34) and ORIF (91.57, SD ± 11.67). The ARIF group showed lower incidence of postoperative complications, especially regarding stiffness (15.4% with ORIF at 21.1%).
The radial head ARIF surgical technique represents a reproducible and safe procedure. A long learning curve is required, but with proper experience, it represents a tool that might be beneficial for patients, as it allows a radial head fracture to be treated with minimal tissue damage, evaluation and treatment of the concomitant lesions, and with no limitation of the positioning of screws.
本研究旨在描述桡骨头骨折的关节镜下复位内固定（ARIF）技术，并在平均10年时将结果与切开复位内固定（ORIF）进行比较。
回顾性选取并评估了32例因桡骨头梅森II型或III型骨折接受ARIF或螺钉固定ORIF治疗的患者。其中13例患者（40.6%）接受了ARIF治疗，19例患者（59.4%）接受了ORIF治疗。平均随访时间为10年（7 - 15年）。所有患者在随访时均接受了MEPI和BMRS评分，并进行了统计分析。
手术时间（P = 0.805）或BMRS（P = 0.181）值无统计学意义。MEPI评分有显著改善（P = 0.036），且ARIF组（98.07，标准差±4.34）与ORIF组（91.57，标准差±11.67）之间存在差异。ARIF组术后并发症发生率较低，尤其是在僵硬方面（ORIF组为21.1%，ARIF组为15.4%）。
桡骨头ARIF手术技术是一种可重复且安全的手术方法。虽然需要较长的学习曲线，但凭借适当的经验，它是一种可能对患者有益的工具，因为它能以最小的组织损伤治疗桡骨头骨折，评估和治疗伴随损伤，且螺钉定位不受限制。
