Acta Orthopaedica et Traumatologica Turcica
Research Article

Importance of detection of capitellar cartilage injuries concomitant with isolated radial head fractures: A retrospective clinical study

1.

Department of Orthopedic Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

2.

Department of Orthopedic Surgery, H Plus Yangji Hospital, Seoul, Korea

3.

Department of Orthopedic Surgery, Seoul St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea

4.

Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea

5.

Department of Orthopedic Surgery, St. Vincent’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea

AOTT 2021; 55: 112-117
DOI: 10.5152/j.aott.2021.20046
Read: 12 Downloads: 3 Published: 06 April 2021

Objective: This study aimed to analyze the injury pattern and clinical importance of concomitant capitellar cartilage defects (CCDs) among patients treated surgically for radial head fracture (RHF).

Methods: A total of 74 patients who were treated surgically for isolated RHFs were retrospectively reviewed. Of these, 12 patients with CCDs (16.2%) were classified as Group I (10 men; mean age, 41.3±12.8 years) and the remaining 62 patients without CCD as Group II (control group) (48 men; mean age, 50.8±13 years). The mean follow-up was 21.3±3.2 months in Group I and 18.7±6.4 in Group II. In Group I, 11 patients underwent open reduction and internal fixation, whereas 1 patient was treated by radial head resection. The preoperative range of motion (ROM) was recorded; the severity of RHF was assessed using the Mason classification. The location, size, and thickness of CCD injuries at the time of surgery were also documented. At the final follow-up, radiological assessment was performed to determine the bone union, and clinical measurements, including ROM and the Mayo elbow performance score (MEPS), were performed. The clinical features of the 2 groups were statistically analyzed.

Results: In Group I, 10 patients showed limited forearm rotation. CCD was located posterolaterally in 11 patients and anterolaterally in 1 patient. At the final follow-up, 11 patients from Group I who underwent open reduction and internal fixation showed complete union of RHF and full recovery of pronation and supination. According to the MEPS, 9 patients exhibited excellent results, and 3 patients exhibited good results. In Group I, RHFs were classified as Mason type II in 7 patients (58.3%) and type III in 4 patients (58.3%). In Group II, RHFs were type II in 45 patients (72.6%) and type III in 17 patients (27.4%). In comparative analyses, there was a significant difference in age (41.3±12.8 versus 50.8±13.0, p=0.041) between the 2 groups. Preoperative pronation/supination was higher in Group II (131.7±36.2) than in Group I (106.3±31.6) (p=0.021). There were no significant differences in sex (p=0.097), follow-up period (p=0.326), Mason type (p=0.482), preoperative extension/flexion (102.3±43.3 [Group I] versus 107.6±44.9 [Group II]) (p=0.584), final follow-up extension/flexion (133.3±10.7 [Group I] versus 126.9±21.2 [Group II]) (p=0.384), pronation/supination (151.2±9.1 [Group I] versus 151.2±13.3 [Group II]) (p=0.558), and the MEPSs (92.9±6.6 [Group I] versus 93.3±7.5 [Group II]) (p=0.701).

Conclusion: If a thorough physical examination of a patient with RHF reveals limited forearm rotation, effort must be made to identify the cause, and the possibility of CCD must be considered. Moreover, there is a need for careful observation during RHF surgery for not only fracture reduction or fixation but also possible CCD.
Level of Evidence: Level III, Therapeutic Study

Cite this article as: Park IJ, Roh YT, Shin SH, Park HY, Jeong C, Kang SH. Importance of detection of capitellar cartilage injuries concomitant with isolated radial head fractures: A retrospective clinical study. Acta Orthop Traumatol Turc 2021; 55(2): 112-7.

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ISSN 1017-995X EISSN 2589-1294