Bindal Shikhar, Pooni Harshaan Singh, Garg Rajnish, Jain Deepak
Department of Orthopedics, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India.
World J Orthop. 2025 Jun 18;16(6):106871. doi: 10.5312/wjo.v16.i6.106871.
Radial head fractures constitute approximately one-third of all elbow fractures, significantly impacting the young and active population. While open reduction and internal fixation is the preferred treatment for displaced fractures, its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty (RHA). RHA provides improved functional outcomes with fewer complications, yet its long-term efficacy remains a topic of debate.
To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.
A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital, Ludhiana over 32 months (January 2021-August 2023). A total of 26 patients with Mason type III and IV fractures were included, with six retrospective and 20 prospective cases. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS), elbow range of motion, pain Visual Analog Scale, and activities of daily living at immediate postoperative, three-month, and six-month follow-ups.
MEPS at 6 months follow up for 4 cases (15.38%) had good scores, and 22 cases (84.62%) had excellent scores, with a mean ± SD of 97.31 ± 6.67. Comparisons showed significant improvement from immediate post-operative to 3 months ( < 0.0001), from immediate post-operative to 6 months ( < 0.0001), and between 3 months and 6 months ( < 0.0001). None of the patients had elbow instability after radial head replacement and 22 cases (84.62%) had no complications, while 3 cases (11.54%) had a stiff elbow, and 1 case (3.85%) had heterotopic ossification.
RHA is an effective treatment for comminuted radial head fractures, providing stable elbow function with minimal complications.
桡骨头骨折约占所有肘部骨折的三分之一，对年轻且活跃的人群有显著影响。虽然切开复位内固定是移位骨折的首选治疗方法，但其在粉碎性骨折中的高并发症发生率导致桡骨头置换术（RHA）的使用越来越多。RHA能改善功能结局且并发症更少，但其长期疗效仍是一个有争议的话题。
评估接受模块化金属假体RHA治疗粉碎性梅森III型和IV型桡骨头骨折患者的功能结局。
在卢迪亚纳的达亚南德医学院和医院进行了一项为期32个月（2021年1月至2023年8月）的基于医院的前瞻性和回顾性研究。共纳入26例梅森III型和IV型骨折患者，其中回顾性病例6例，前瞻性病例20例。在术后即刻、3个月和6个月随访时，使用梅奥肘关节功能评分（MEPS）、肘关节活动范围、疼痛视觉模拟量表和日常生活活动来评估功能结局。
随访6个月时，4例（15.38%）患者MEPS评分良好，22例（84.62%）患者评分优秀，平均±标准差为97.31±6.67。比较显示，从术后即刻到3个月（<0.0001）、从术后即刻到6个月（<0.0001）以及在3个月和6个月之间（<0.0001）均有显著改善。桡骨头置换术后无患者出现肘关节不稳定，22例（84.62%）患者无并发症，3例（11.54%）患者肘关节僵硬，1例（3.85%）患者出现异位骨化。
RHA是治疗粉碎性桡骨头骨折的有效方法，能提供稳定的肘关节功能且并发症最少。
