Patrick Cole M, Sandler Alexis B, Klahs Kyle J, Scanaliato John P, Baird Michael D, Parnes Nata
Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, Fort Bliss, 18511 Highlander Medics St., El Paso, TX 79918, USA.
Department of Orthopaedics, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
J Clin Med. 2025 Sep 6;14(17):6312. doi: 10.3390/jcm14176312.
: Radial head arthroplasty (RHA) and open reduction and internal fixation (ORIF) have emerged as predominant methods of surgical management for radial head fractures. The objective of this study was to evaluate national trends in management of radial head fractures among ABOS oral examination candidates and to compare complication rates between RHA and ORIF. : A search of the American Board of Orthopaedic Surgery (ABOS) oral examination database identified radial head fractures treated with RHA or ORIF between 2003 and 2021 in patients 18 years or older. : RHA cases increased significantly from 2003-2021 ( < 0.001). Patients undergoing RHA were older (52.4 years vs. 42.9 years, < 0.001) and predominantly female (60.8% vs. 45.7%, < 0.001). Medical and surgical complications within 60 days were higher after RHA (2.9% vs. 1.6%, = 0.012; 24.9% vs. 20.4%, = 0.001), most commonly stiffness (10.8% vs. 7.1%, < 0.001), nerve injury (3.3% vs. 2.7%, = 0.26), and implant failure (3.4% vs. 2.4%, = 0.064). Non-union or delayed union (0.5% vs. 2.5%, < 0.001) was significantly higher after ORIF, and fracture (1.1% vs. 0.3%, = 0.008) was significantly higher after RHA. The highest proportion of RHA to ORIF was performed by surgeons with shoulder and elbow fellowship training ( < 0.001). : Among ABOS Candidates, RHA volume surpassed ORIF for radial head fractures in 2010. Surgical complication rates for radial head fractures are high at 60 days follow-up for both procedures. RHA is associated with higher complication rates, especially stiffness; however, similar reoperation and readmission rates suggest that RHA may have been selected for more complex injuries.
桡骨头置换术（RHA）和切开复位内固定术（ORIF）已成为桡骨头骨折手术治疗的主要方法。本研究的目的是评估美国骨科医师协会（ABOS）口试考生中桡骨头骨折治疗的全国趋势，并比较RHA和ORIF之间的并发症发生率。：对美国骨科医师协会（ABOS）口试数据库进行检索，确定了2003年至2021年期间18岁及以上患者中接受RHA或ORIF治疗的桡骨头骨折。：2003 - 2021年RHA病例显著增加（<0.001）。接受RHA的患者年龄更大（52.4岁对42.9岁，<0.001），且以女性为主（60.8%对45.7%，<0.001）。RHA后60天内的医疗和手术并发症更高（2.9%对1.6%，=0.012；24.9%对20.4%，=0.001），最常见的是僵硬（10.8%对7.1%，<0.001）、神经损伤（3.3%对2.7%，=0.26）和植入物失败（3.4%对2.4%，=0.064）。ORIF后骨不连或延迟愈合（0.5%对2.5%，<0.001）显著更高，而RHA后骨折（1.1%对0.3%，=0.008）显著更高。进行RHA与ORIF比例最高的是接受过肩肘专科培训的外科医生（<0.001）。：在ABOS考生中，2010年桡骨头骨折的RHA手术量超过了ORIF。两种手术在60天随访时桡骨头骨折的手术并发症发生率都很高。RHA与更高的并发症发生率相关，尤其是僵硬；然而，相似的再次手术和再入院率表明，RHA可能是被选用于更复杂的损伤。
