BACKGROUND 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 ...BACKGROUND 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.AIM To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.METHODS 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 via Visual Analog Scale,and activities of daily living at immediate postoperative,three-month,and six-month follow-ups.RESULTS 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(P<0.0001),from immediate post-operative to 6 months(P<0.0001),and between 3 months and 6 months(P<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.CONCLUSION RHA is an effective treatment for comminuted radial head fractures,providing stable elbow function with minimal complications.展开更多
BACKGROUND Accurate surgical fixation of intra-articular distal humerus fractures require olecranon osteotomy.Repair of osteotomy is achieved with a variety of techniques but no consensus has been achieved regarding t...BACKGROUND Accurate surgical fixation of intra-articular distal humerus fractures require olecranon osteotomy.Repair of osteotomy is achieved with a variety of techniques but no consensus has been achieved regarding the optimum technique for fixing the olecranon osteotomy.In this retrospective study,we compared the functional and radiological outcome of the two commonly used techniques of fixing olecranon osteotomy after fixing distal humerus intra-articular fractures.We hypothesized that olecranon osteotomy fixed with 6.5 mm cancellous intramedullary screw alone yielded better radiological and functional outcome than fixation with cerclage wire over cancellous screw applied in figure of eight as tension band wiring(TBW).AIM To determine the radiological and functional outcome of olecranon osteotomy fixation with cancellous screw alone vs cancellous screw combined with cerclage wiring applied as TBW.METHODS This retrospective study was conducted in Lady Reading Hospital Peshawar Pakistan.Intra-articular distal humerus fractures fulfilling the inclusion criteria and operated during 2023 to 2025 were included.Olecranon osteotomy fixation with 6.5 mm cancellous screw alone was labelled as group A while cerclage wire over cancellous screw in figure of eight as TBW were labelled as group B.The demographics,radiological and functional outcome in both groups were compared at one year using Mayo Elbow Performance Score and Quick Disabilities of the Arm,Shoulder,and Hand Score.RESULTS We included 32 patients in this study.The mean age of group A patients was 34±5.5 years while group B had a mean age of 34±6.2 years.Radiological union of olecranon osteotomy was achieved in all cases in both groups.Functional outcome however was significantly better in group A than in group B(P<0.05).The Mayo Elbow Performance Score was excellent in 14(87.5%)and good in 2(12.5%)patients in group A while 7(43.47%)patients had excellent outcome,5(31.25%)good and 4(25%)had fair outcome in group B.The mean Quick Disabilities of the Arm,Shoulder,and Hand Score was 24.5±2.1 and 78.1±12.1 in group A and B respectively(P<0.05).CONCLUSION Similar radiological union was achieved in all patients of olecranon osteotomy treated with intramedullary screw alone and intramedullary screw with TBW.Functional outcome however was significantly better in intramedullary screw alone than in intramedullary screw with TBW.展开更多
文摘BACKGROUND 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.AIM To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.METHODS 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 via Visual Analog Scale,and activities of daily living at immediate postoperative,three-month,and six-month follow-ups.RESULTS 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(P<0.0001),from immediate post-operative to 6 months(P<0.0001),and between 3 months and 6 months(P<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.CONCLUSION RHA is an effective treatment for comminuted radial head fractures,providing stable elbow function with minimal complications.
文摘BACKGROUND Accurate surgical fixation of intra-articular distal humerus fractures require olecranon osteotomy.Repair of osteotomy is achieved with a variety of techniques but no consensus has been achieved regarding the optimum technique for fixing the olecranon osteotomy.In this retrospective study,we compared the functional and radiological outcome of the two commonly used techniques of fixing olecranon osteotomy after fixing distal humerus intra-articular fractures.We hypothesized that olecranon osteotomy fixed with 6.5 mm cancellous intramedullary screw alone yielded better radiological and functional outcome than fixation with cerclage wire over cancellous screw applied in figure of eight as tension band wiring(TBW).AIM To determine the radiological and functional outcome of olecranon osteotomy fixation with cancellous screw alone vs cancellous screw combined with cerclage wiring applied as TBW.METHODS This retrospective study was conducted in Lady Reading Hospital Peshawar Pakistan.Intra-articular distal humerus fractures fulfilling the inclusion criteria and operated during 2023 to 2025 were included.Olecranon osteotomy fixation with 6.5 mm cancellous screw alone was labelled as group A while cerclage wire over cancellous screw in figure of eight as TBW were labelled as group B.The demographics,radiological and functional outcome in both groups were compared at one year using Mayo Elbow Performance Score and Quick Disabilities of the Arm,Shoulder,and Hand Score.RESULTS We included 32 patients in this study.The mean age of group A patients was 34±5.5 years while group B had a mean age of 34±6.2 years.Radiological union of olecranon osteotomy was achieved in all cases in both groups.Functional outcome however was significantly better in group A than in group B(P<0.05).The Mayo Elbow Performance Score was excellent in 14(87.5%)and good in 2(12.5%)patients in group A while 7(43.47%)patients had excellent outcome,5(31.25%)good and 4(25%)had fair outcome in group B.The mean Quick Disabilities of the Arm,Shoulder,and Hand Score was 24.5±2.1 and 78.1±12.1 in group A and B respectively(P<0.05).CONCLUSION Similar radiological union was achieved in all patients of olecranon osteotomy treated with intramedullary screw alone and intramedullary screw with TBW.Functional outcome however was significantly better in intramedullary screw alone than in intramedullary screw with TBW.
