Gonzalez-Morgado Diego, Mendoza-Aguilo Carlos, Gallardo-Calero Irene, Martinez-Collado Pablo, Bustos-Mardones Andres, Bargallo-Granero Julia, Lluch-Bergada Alex, Esteban-Feliu Ignacio
Orthopaedic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Hand and Microsurgery Unit, Orthopaedic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Shoulder Elbow. 2025 Apr;17(2):209-218. doi: 10.1177/17585732241255952. Epub 2024 May 20.
Fixation of radial head fractures with neck involvement presents challenges. It remains unclear whether the outcomes of head-to-neck screw fixation are similar to those of arthroplasty in this scenario. We conducted a retrospective cohort study to evaluate the clinical outcomes of these two methods for treating such fractures.
Demographic data, fracture type, number of fragments, and concomitant injuries were recorded. Range of motion, Visual Analogue Scale for pain, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand at three-year follow-up, complications, and reintervention were compared.
A total of 14 patients underwent fixation with head-to-neck screws, and 15 an arthroplasty. Baseline characteristics between groups were similar ( > .05). Satisfactory range of motion (arc > 100°) was achieved in nine patients (64%) in the fixation group, and eight patients (53%) in the arthroplasty group ( = .55). The mean Visual Analogue Scale, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand were 1.2 ± 1.2, 91.7 ± 10.7, and 9.1 ± 1, respectively, ( = .651, = .651, and = .155). Three patients (21%) in the fixation group underwent a reintervention and three (20%) in the arthroplasty group (= .639).
Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement.
伴有颈部损伤的桡骨头骨折的固定具有挑战性。在这种情况下，头颈螺钉固定的效果是否与关节成形术相似仍不清楚。我们进行了一项回顾性队列研究，以评估这两种治疗此类骨折方法的临床效果。
记录人口统计学数据、骨折类型、骨折块数量和合并损伤。比较三年随访时的活动范围、疼痛视觉模拟评分、梅奥肘关节功能评分以及手臂、肩部和手部快速残疾评估结果、并发症和再次干预情况。
共有14例患者接受了头颈螺钉固定，15例接受了关节成形术。两组间的基线特征相似（P>0.05）。固定组9例患者（64%）和关节成形术组8例患者（53%）实现了满意的活动范围（弧度>100°）（P=0.55）。平均疼痛视觉模拟评分、梅奥肘关节功能评分以及手臂、肩部和手部快速残疾评估结果分别为1.2±1.2、91.7±10.7和9.1±1（P=0.651、P=0.651和P=0.155）。固定组3例患者（21%）接受了再次干预，关节成形术组3例患者（20%）接受了再次干预（P=0.639）。
对于伴有颈部损伤的低粉碎性桡骨头骨折，头颈螺钉固定和桡骨头关节成形术的术后效果相似。
