gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Clinical outcome of the radial head and neck fracture treated by headless screw fixation

Meeting Abstract

  • presenting/speaker Koichi Yano - Seikeikai Hospital, Sakai City, Japan
  • Yasunori Kaneshiro - Seikeikai Hospital, Sakai City, Japan
  • Ryo Sasaki - Seikeikai Hospital, Sakai City, Japan
  • Seungho Hyun - Seikeikai Hospital, Sakai City, Japan
  • Hideki Sakanaka - Seikeikai Hospital, Sakai City, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-239

doi: 10.3205/19ifssh0069, urn:nbn:de:0183-19ifssh00698

Published: February 6, 2020

© 2020 Yano et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: We treated the combined fracture of the radial head and neck by headless screw fixation only. The purpose of this study is to report the clinical and radiographic outcome.

Methods: This study included the patients who were suffered combination of the radial head and neck fracture, treated by headless screw fixation only, followed more than nine months. They are four men and four female. Average age at surgery was 40 years-old (19-62). Average number of the radial head was 3.3 (2-5). Associated injuries were none in four patients, ulnar styloid fracture in one, lateral collateral ligament injury of the elbow in one, olecranon fracture in one, scapholunate dissociation in one. In surgical treatment, the multiple fragments of the radial head was taken to the outside and fixed by screws. When the bone defect was found at radial neck, the bone graft was harvested form proximal ulna. After then, radial head was fixed to the radial neck by screw. Immobilization of the elbow and forearm was performed for two weeks postoperatively. From third week postoperatively, the elbow and forearm were started to exercise. Clinical outcome was examined by the range of the elbow and forearm motion at final follow-up. Mayo elbow performance score was also assessed. Radiological examination was performed for bone union, arthritic change. Postoperative displace of the bony fragment was assessed by the angle between bony axis of the proximal metaphysis of the radius and articular surface of the radial head.

Results and Conclusions: Average postoperative follow-up period was 418 days. Bone graft was performed in 2 patients. Average range of motion was as following; elbow flexion: 139° (130-145), elbow extension: -4° (-15-0), forearm supination: 88° (80-90), forearm pronation: 84° (60-90). Average Mayo elbow performance score was 98.1 (85-100). On radiographical examination, bony union was obtained in all patients and arthrosis was found in none. Postoperative displace was minimal because there was no significant difference in the angle between just after operation and final follow-up.

Our study showed that the headless screw fixation for radial head and neck fracture maintained reduced position of the fracture site and did not cause the limited motion of the forearm rotation significantly. For the case with good quality of bone, the headless screw fixation could be one of the surgical fixations.