Closed reduction and internal fixation with elastic nail for Mason type <b>Ⅱ</b> radial head fracture in adults_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Xu ^1,2 ,  YIN Hailei ³ , LU Jianfeng ³

1. Qingdao University, Qingdao Shandong, 266071, P.R.China;
2. Department of Orthopedics, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266071, P.R.China;
3. The Second Department of Orthopedics, No.401 Hospital of the Chinese PLA, Qingdao Shandong, 266071, P.R.China;

Corresponding author：

YIN Hailei, Email: stonethrough@sina.com

Keywords：

Radial head fracture; Mason type Ⅱ; elastic nail; closed reduction; internal fixation; adult

DOI：

10.7507/1002-1892.201903117

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Objective To investigate the effectiveness of closed reduction and internal fixation with elastic nails in treatment of Mason type Ⅱ radial head fracture in adults.Methods A clinical data of 28 patients with Mason type Ⅱ radial head fractures between May 2013 and March 2017 was retrospectively analyzed. Thirteen patients were treated with closed reduction and internal fixation with elastic nails (trial group); 15 patients were treated with open reduction and internal fixation with Herbert screws (control group). There was no significant difference in gender, age, cause of injury, side of fracture, and the time from injury to operation between the two groups (P>0.05). The operation time, blood loss, and fluoroscopy times in the two groups were recorded and compared. Postoperative X-ray films were used to evaluate the bone healing, heterotopic ossification, and necrosis of radial head. The effectiveness was evaluated according to Mayo score criteria of the elbow at last follow-up. Results All patients were followed up 12-30 months (mean, 21.9 months). The operation time and blood loss were significantly less in the trial group than in the control group (P<0.05), while the fluoroscopy times significantly increased in the trial group than in the control group (P<0.05). X-ray films showed that all fractures healed with the bone healing time of (2.85±0.69) months in the trial group and (3.35±0.88) months in the control group. There was no significant difference in bone healing time between the two groups (t=1.654, P=0.110). Heterotopic ossification occurred in 2 cases in the control group. At last follow-up, there was no significant difference in the Mayo scores between the trial group (90.6±5.3) and the control group (86.4±7.1) (t=1.750, P=0.092).Conclusion Closed reduction and internal fixation with elastic nails, as a minimally invasive technique, has advantages of short operation time and less bleeding in the treatment of Mason type Ⅱ radial head fracture.

Citation： GAO Xu, YIN Hailei, LU Jianfeng. Closed reduction and internal fixation with elastic nail for Mason type Ⅱ radial head fracture in adults. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(8): 981-985. doi: 10.7507/1002-1892.201903117 Copy

1.	Kaas L, Struijs PA, Ring D, et al. Treatment of Mason type Ⅱ radial head fractures without associated fractures or elbow dislocation: a systematic review. J Hand Surg (Am), 2012, 37(7): 1416-1421.
2.	Kachooei AR, Ring D. Evaluation of radiocapitellar arthritis in patients with a second radiograph at least 2 years after nonoperative treatment of an isolated radial head fracture. Arch Bone Jt Surg, 2017, 5(6): 375-379.
3.	Herbertsson P, Josefsson PO, Hasserius R, et al. Uncomplicated Mason type Ⅱ and Ⅲ fractures of the radial head and neck in adults. A long-term follow-up study. J Bone Joint Surg (Am), 2004, 86(3): 569-574.
4.	Yoon A, King GJ, Grewal R. Is ORIF superior to nonoperative treatment in isolated displaced partial articular fractures of the radial head? Clin Orthop Relat Res, 2014, 472(7): 2105-2012.
5.	Guzzini M, Vadalà A, Agrò A, et al. Nonsurgical treatment of Mason type Ⅱ radial head fractures in athletes. A retrospective study. G Chir, 2017, 37(5): 200-205.
6.	Khalfayan EE, Culp RW, Alexander AH. Mason type Ⅱ radial head fractures: operative versus nonoperative treatment. J Orthop Trauma, 1992, 6(3): 283-289.
7.	Morrey BF, Bryan RS, Dobyns JH, et al. Total elbow arthroplasty. A five-year experience at the Mayo Clinic. J Bone Joint Surg (Am), 1981, 63(7): 1050-1063.
8.	吴敏, 官建中, 肖玉周, 等. 经皮克氏针撬拨复位弹性髓内钉固定治疗儿童重度桡骨颈骨折. 中国修复重建外科杂志, 2015, 29(12): 1478-1482.
9.	Cha SM, Shin HD, Kim KC, et al. Percutaneous reduction and leverage fixation using K-wires in paediatric angulated radial neck fractures. Int Orthop, 2012, 36(4): 803-809.
10.	鲍琨, 陈博昌, 冯林, 等. 儿童桡骨颈骨折的治疗. 中华小儿外科杂志, 2012, 33(2): 131-135.
11.	Ashish Devgan, Raj Singh, Suresh Kumar, et al. Indirect reduction and intramedullary pinning in severely displaced radial neck fractures in children. Int J Clin Med, 2011, 2(2): 75-78.
12.	李卫平, 陈世海, 裴生太, 等. 钛合金弹性钉治疗小儿四肢长骨骨折. 国际骨科学杂志, 2011, 32(6): 402-404.
13.	陈云丰, 张睿, 张弛, 等. 钛制弹性钉与重建钢板在治疗移位锁骨中段骨折中的临床疗效比较. 中华创伤骨科杂志, 2010, 12(11): 1006-1009.
14.	Jackson JD, Steinmann SP. Radial head fractures. Hand Clin, 2007, 23(2): 185-193.
15.	Duckworth AD, Clement ND, Jenkins PJ, et al. The epidemiology of radial head and neck fractures. J Hand Surg (Am), 2012, 37(1): 112-119.
16.	Métaizeau JP, Prévot J, Schmitt M. Reduction and fixation of fractures of the neck of the radious be centro-medullary pinning. Original technic. Rev Chir Orthop, 1980, 66(1): 47-49.
17.	Sandmann GH, Crönlein M, Neumaier M, et al. Reduction and stabilization of radial neck fractures by inramedullary pinning: a technique not only for children. Eur J Med Res, 2016, 21: 15.
18.	Serbest S, Gürger M, Tosun HB, et al. Closed reduction and intramedullary pinning in the treatment of adult radial neck fractures: a case report. Pan Afr Med J, 2015, 20: 434.

1. Kaas L, Struijs PA, Ring D, et al. Treatment of Mason type Ⅱ radial head fractures without associated fractures or elbow dislocation: a systematic review. J Hand Surg (Am), 2012, 37(7): 1416-1421.
2. Kachooei AR, Ring D. Evaluation of radiocapitellar arthritis in patients with a second radiograph at least 2 years after nonoperative treatment of an isolated radial head fracture. Arch Bone Jt Surg, 2017, 5(6): 375-379.
3. Herbertsson P, Josefsson PO, Hasserius R, et al. Uncomplicated Mason type Ⅱ and Ⅲ fractures of the radial head and neck in adults. A long-term follow-up study. J Bone Joint Surg (Am), 2004, 86(3): 569-574.
4. Yoon A, King GJ, Grewal R. Is ORIF superior to nonoperative treatment in isolated displaced partial articular fractures of the radial head? Clin Orthop Relat Res, 2014, 472(7): 2105-2012.
5. Guzzini M, Vadalà A, Agrò A, et al. Nonsurgical treatment of Mason type Ⅱ radial head fractures in athletes. A retrospective study. G Chir, 2017, 37(5): 200-205.
6. Khalfayan EE, Culp RW, Alexander AH. Mason type Ⅱ radial head fractures: operative versus nonoperative treatment. J Orthop Trauma, 1992, 6(3): 283-289.
7. Morrey BF, Bryan RS, Dobyns JH, et al. Total elbow arthroplasty. A five-year experience at the Mayo Clinic. J Bone Joint Surg (Am), 1981, 63(7): 1050-1063.
8. 吴敏, 官建中, 肖玉周, 等. 经皮克氏针撬拨复位弹性髓内钉固定治疗儿童重度桡骨颈骨折. 中国修复重建外科杂志, 2015, 29(12): 1478-1482.
9. Cha SM, Shin HD, Kim KC, et al. Percutaneous reduction and leverage fixation using K-wires in paediatric angulated radial neck fractures. Int Orthop, 2012, 36(4): 803-809.
10. 鲍琨, 陈博昌, 冯林, 等. 儿童桡骨颈骨折的治疗. 中华小儿外科杂志, 2012, 33(2): 131-135.
11. Ashish Devgan, Raj Singh, Suresh Kumar, et al. Indirect reduction and intramedullary pinning in severely displaced radial neck fractures in children. Int J Clin Med, 2011, 2(2): 75-78.
12. 李卫平, 陈世海, 裴生太, 等. 钛合金弹性钉治疗小儿四肢长骨骨折. 国际骨科学杂志, 2011, 32(6): 402-404.
13. 陈云丰, 张睿, 张弛, 等. 钛制弹性钉与重建钢板在治疗移位锁骨中段骨折中的临床疗效比较. 中华创伤骨科杂志, 2010, 12(11): 1006-1009.
14. Jackson JD, Steinmann SP. Radial head fractures. Hand Clin, 2007, 23(2): 185-193.
15. Duckworth AD, Clement ND, Jenkins PJ, et al. The epidemiology of radial head and neck fractures. J Hand Surg (Am), 2012, 37(1): 112-119.
16. Métaizeau JP, Prévot J, Schmitt M. Reduction and fixation of fractures of the neck of the radious be centro-medullary pinning. Original technic. Rev Chir Orthop, 1980, 66(1): 47-49.
17. Sandmann GH, Crönlein M, Neumaier M, et al. Reduction and stabilization of radial neck fractures by inramedullary pinning: a technique not only for children. Eur J Med Res, 2016, 21: 15.
18. Serbest S, Gürger M, Tosun HB, et al. Closed reduction and intramedullary pinning in the treatment of adult radial neck fractures: a case report. Pan Afr Med J, 2015, 20: 434.

Chinese Journal of Reparative and Reconstructive Surgery

Closed reduction and internal fixation with elastic nail for Mason type Ⅱ radial head fracture in adults

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