Short term comparative study of radial head fracture treated with radial head platting and radial head excision

Abstract

Introduction:The elbow is the joint between your upper arm and your forearm. It is made of several joints. One of these is called the radial-capatellar joint. The disc-shaped radial head moves and rotates against a round part of the humerus called the capitellum. As your radial head moves against the capitellum, it allows you to turn your palm up (supination) and down (pronation), as well as allowing you to bend and straighten your elbow. The elbow allows you to move your hand in space and put it where you want it. The radial head is the key to this motion. Aims and Objectives:The aim of our study to compare the functional outcome in operative modalities in radial head fracture like radial head platting, excision in terms of range of movement, functional outcome, return to normal previous work. Materials and Methods: After institutional board approval and informed consent from patients, this prospective case controlled clinical study as carried out in 30 patient, with ASA physical status 1 and 2. All patients had anterior -posterior and lateral radiographs of elbow. The patients will be assessed preoperatively in form of range of movements, pain, stability.11 cases operated for radial head platting and 19 cases operated for radial head excision and assessed at follow up visits for range of movements, return to work and graded according to mayo's elbow score. Results: Among 30 patient, according to mayo's elbow score results are excellent in 18.18%, good in 45.45%, fair in 36.36% in patients treated with radial head platting and excellent in 36.84%, good in 63.15% patients treated with radial head excision. Average trauma and surgery interval was 3 to 5 days. The duration of hospital stay post operatively was less in radial head excision 2 to 3 days and 5 to 7 days for radial head platting. The mean time for union in radial head platting is 8 to 10 weeks except one patient had delayed union and it took 12 week until osseous union was evident radiographically. The average time for return to normal work was 11 weeks in radial head excision and 13 weeks in radial head platting. Conclusion: Radial head excision offers the following advantages when compared with radial head platting. a) better stability b) full strength c) good functional outcome. In our study, the rehabilitation time was much shorter for fractures operated with excision when compared with ORIF. Excision provides for short operating time, short hospital stay and early rehabilitation than ORIF. While ORIF have better functional outcome and less complication. If adequate fixation done in ORIF excels better results.