On-table reconstruction and fixation of Mason type III radial head fractures

Gaurav, Kumar; Sharma, Gaurav; Farooque, Kamran; Vp, Sharma; Jain, Vaibhav; Singh, Rohit; Morey, Vivek Machhindra

doi:10.1016/j.cjtee.2015.11.005

Cited by 13 publications

(26 citation statements)

References 17 publications

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“…Particularly, on-table reconstruction technique has been reported and veri ed clinically. Several studies that exclusively focus on such technique for the complex radial head fractures have revealed satisfactory functional outcomes [7][8][9]. This technique is not limited to the narrowing anatomical joint space, and allows the reconstructed radial head to replant with the use of plate, which should be worthy of supporting and popularizing.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, stable xation in fracture site allows patient to functional exercise early and promotes bone union. Kiran Kumar et al [8] have reported that only 3 of the 6 patients treated with on-table reconstruction achieve fracture healing after a mean follow-up of 25 months, and one case occurs avascular necrosis of radial head. There is a strong possibility that these complications are attributed to the unstable plate xation.…”

Section: Discussionmentioning

confidence: 99%

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A hybrid technique combining intramedullary pinning with extramedullary plate fixation in unstable and comminuted radial head fractures following on-table reconstruction

Gao

Dai²,

Yin³

et al. 2021

Preprint

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Background: Management of comminuted radial fractures remains controversial. Currently, the emergence of on-table reconstruction technique has made fixation in comminuted radial head fractures more viable. However, the present study reported an intro-operative unstable displacement from the reconstructed radial head to the neck during plate fixation, characterized by a poor radiocapitellar contact and incongruity between the radial head and neck. A hybrid technique combining with intramedullary pining was performed in our study to restore the normal alignment and maintain the stability of fixation. Therefore, the purpose of this article aimed to prove the feasibility of unstable comminuted radial head fractures treated with the extramedullary plate and intramedullary pinning fixation using titanium elastic nails. Methods: The clinical, functional and radiographic outcomes of the groups were compared during follow-up. The radiographic examination was conducted to evaluate the status of bone union, heterotopic ossification and post-traumatic arthritis. The functional assessment was performed to evaluate clinical effects, which included measurements of range of motion (ROM) in the elbow, Visual Analog Scale (VAS) score, Elbow Self-Assessment score (ESAS), Mayo Elbow Performance score (MEPS), and Disabilities of the Arm, Shoulder, and Hand (DASH)Outcome Measure score.Results: Fifteen patients with unstable fractures were participated with an average follow-up of (37.2±5.8) months for the experimental group and (33.2±7.1) months for the control group, respectively. The ROM of the elbow and functional outcomes in the experimental group, including MEPS and DASH, were significantly superior to the control group. However, no significant difference was observed in the mean VAS score between two groups. In the last follow-up, two patients with post-traumatic arthritis rated as grades 1 and two with heterotopic ossifications were observed in the experimental group. In the control group, degenerative changes were observed in four cases (grade 1 in three cases and grade 2 in one case) and heterotopic ossifications rated as grade I were found in two patients. Conclusion: Collectively, intramedullary pinning with extramedullary plate fixation is feasible in unstable comminuted radial head fractures, which can be considered as a remedial surgery for on-table reconstruction technique. Trial registration: This study was retrospectively registered

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A hybrid technique combining intramedullary pinning with extramedullary plate fixation in unstable and comminuted radial head fractures following on-table reconstruction

Gao

Dai²,

Yin³

et al. 2021

Preprint

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“…The on-table reconstruction technique refers to the removal of all the fracture pieces of the radial head and precise reduction under direct vision on the operating table. As Masson III fractures involving the articular surface of the radial head are often more than three pieces, the in vivo space for reduction is narrow, and reduction is usually more di cult [14] . In our study, the larger fracture fragments were removed out and reduced by screws,the small fracture fragments were temporarily xed with multiple ne Kirschner wires.…”

Section: Discussionmentioning

confidence: 99%

Effects of an on-table Reconstruction Technique Combined With Miniplate Internal Fixation and Prosthesis for the Treatment of Isolated Mason III Radial Head Fractures

Han

Wang²,

et al. 2021

Preprint

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Background: In this retrospective study we analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with an on-table reconstruction technique combined with miniplate internal fixation or prosthesis.Methods: This study included 42 patients affected by isolated radial head Mason III fractures and treated between Jan 2012 and Jan 2019. Twenty-four patients (average age 45.6 years) were treated with an on-table reconstruction technique combined with miniplate internal fixation. The remaining 18 (average age 44.5 years) were treated with prosthesis. From a clinical point of view, we evaluated the patients according to the Broberg–Morrey scoring system and the (disabilities of the arm, shoulder, and hand) DASH questionnaire for parameters.Results: We found similar results in both the groups according to Broberg–Morrey score system and the DASH questionnaire at the last follow-up. The scores of the prosthesis group were better than those of the internal fixation group at the 1st, 3rd, and 6th month follow-up post-operation.Conclusion: Both the on-table reconstruction technique combined with the miniplate internal fixation and prosthesis can be effective in treating patients with isolated Mason III radial head fractures. There was no difference in elbow function between the two groups at the last follow-up; however, a prosthesis favors early functional recovery of the elbow.

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“…In their study, 2 patients with Mason type III and 4 patients with Mason type IV radial head fractures were treated with on-table reconstruction and fixation using low-profile mini-plates. In another study by Kiran Kumar et al, [11] 6 patients with Mason type III fractures were treated by an on-table reconstruction technique. The results were rated as excellent in 2 patients, good in 3 patients, and fair in 1 patient.…”

Section: Discussionmentioning

confidence: 99%

“…[7,9] Because the radial head plays an important role in maintaining the stability of the elbow, many investigators recommend preservation of the radial head, either by ORIF or radial head arthroplasty. [1,10,11]…”

Section: Introductionmentioning

confidence: 99%

Use of surgical glue for Mason type III radial head fractures

Chen

Zhou

2019

Medicine

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Rationale: A Mason type III radial head fracture, which is characterized by comminuted fragments of the radial head, is a severe injury. Open reduction and internal fixation (ORIF) is an alternative treatment method; however, the technique of using an on-table reduction in combination with surgical glue is rarely reported. Patient concerns: A 48-year-old man was admitted to our department with complaints of elbow pain after falling down. Elbow radiography and computed tomography (CT) demonstrated characteristics of fractures before the operation. Diagnosis: Radiographic images showed a Mason type III radial head fracture. Interventions: The patient underwent ORIF at our hospital. During the operation, the technique of on-table reconstruction combined with surgical glue was used. Outcomes: The patient recovered well and was able to participate in his usual work. Lessons: Mason type III radial head fractures could be treated with ORIF, and a satisfactory result could be anticipated, thus avoiding a radial head replacement or resection. Anatomical reduction of a comminuted radial head could be obtained via an on-table reconstruction and application of surgical glue.

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On-table reconstruction and fixation of Mason type III radial head fractures

Cited by 13 publications

References 17 publications

A hybrid technique combining intramedullary pinning with extramedullary plate fixation in unstable and comminuted radial head fractures following on-table reconstruction

A hybrid technique combining intramedullary pinning with extramedullary plate fixation in unstable and comminuted radial head fractures following on-table reconstruction

Effects of an on-table Reconstruction Technique Combined With Miniplate Internal Fixation and Prosthesis for the Treatment of Isolated Mason III Radial Head Fractures

Use of surgical glue for Mason type III radial head fractures

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