Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, 246 East 20th Street, New York, NY, 10003, USA.
Eur J Orthop Surg Traumatol. 2023 Oct;33(7):3099-3106. doi: 10.1007/s00590-023-03532-y. Epub 2023 Apr 8.
The aim of this study is to evaluate 90-day outcomes and complications following radial head arthroplasty (RHA) for Mason Type III and IV radial head fractures (RHFs) and determine factors predisposing patients to early complications and revision surgery.
Patients undergoing RHA for Mason Type III and IV RHFs were identified retrospectively from an institutional database. Postoperative complications, reoperations, elbow range of motion, radiographs and concomitant injuries on the ipsilateral upper extremity were reviewed. Additionally, injuries were sub-classified as low-energy trauma (LET) or high-energy trauma (HET). Univariate logistic regression was performed to evaluate the risk for complications using patient factors not limited to the presence of concomitant ligamentous or bony injuries. P values < 0.05 were considered statistically significant.
Seventy four patients were included in our study with an average follow-up time of 12.7 months. Complications within 90-days of operation occurred in 8.1% of patients: heterotopic ossification (4.1%), superficial wound dehiscence (2.7%), and posterior interosseous nerve palsy (1.4%). No patients required readmission or revision surgery in the 90-day postoperative period. Univariate regression analysis did not demonstrate a significant association between diabetes, ASA status, HET versus LET, or the presence of concomitant injury. Concomitant injuries were found in 92% of patients.
Radial head arthroplasty for RHFs demonstrates a low complication rate in the short-term. Diabetes, ASA class, high versus low energy trauma, and presence of concomitant injury were not found to be associated with higher complication rates in the 90-day postoperative period.
Level of evidence IV, retrospective case series.
本研究旨在评估桡骨头置换术（RHA）治疗 Mason Ⅲ型和Ⅳ型桡骨头骨折（RHF）的 90 天结果和并发症，并确定导致患者早期并发症和翻修手术的相关因素。
我们从一个机构数据库中回顾性地确定了接受 RHA 治疗 Mason Ⅲ型和Ⅳ型 RHF 的患者。术后并发症、再次手术、肘部活动范围、X 线片以及同侧上肢的伴随损伤均进行了回顾。此外，将损伤分为低能创伤（LET）和高能创伤（HET）。采用单变量逻辑回归分析，评估了不限于存在伴随韧带或骨损伤的患者因素发生并发症的风险。P 值<0.05 被认为具有统计学意义。
我们的研究纳入了 74 例患者，平均随访时间为 12.7 个月。术后 90 天内发生的并发症发生率为 8.1%：异位骨化（4.1%）、浅表伤口裂开（2.7%）和骨间后神经麻痹（1.4%）。没有患者在术后 90 天内需要再次入院或翻修手术。单变量回归分析并未显示糖尿病、ASA 状态、HET 与 LET 之间、或是否存在伴随损伤与更高的并发症发生率之间存在显著相关性。92%的患者存在伴随损伤。
桡骨头置换术治疗 RHF 在短期内并发症发生率较低。糖尿病、ASA 分级、高能与低能创伤、是否存在伴随损伤与术后 90 天内更高的并发症发生率之间无相关性。
IV 级，回顾性病例系列研究。
