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Riduzione e osteosintesi delle fratture del capitello radiale: indicazioni e tecnica chirurgica

Open reduction and internal fixation of radial head fractures: indications and surgical technique

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Riassunto

Riassunto

L’importante ruolo stabilizzatore del capitello radiale rende la sua ricostruzione mediante osteosintesi, qualora possibile, il trattamento di scelta di tali fratture.

Obiettivi

Valutazione a medio-termine delle fratture di capitello radiale sottoposte a riduzione cruenta e sintesi interna.

Metodi

Diciannove pazienti sottoposti a osteosintesi del capitello radiale tra il 2006 e il 2010 (11 fratture tipo Mason II, 5 Mason III e 3 Mason IV) sono stati valutati retrospettivamente a una distanza media di 33 mesi dall’intervento. Per la sintesi sono state utilizzate placche e viti libere in 9 casi, viti libere cannulate in 8 casi, fili di Kirschner con placca in un caso e solo placca in un caso.

Risultati

L’articolarità del gomito ha raggiunto i seguenti valori medi: flessione 129,2o, deficit di estensione 7,9o, pronazione 60o e supinazione 53,4o. Sulla base del Mayo Elbow Performace Score sono stati ottenuti 12 risultati eccellenti, 1 buono, 4 discreti e 2 scarsi. Il punteggio medio del Disability of the Arm, Shoulder and Elbow (DASH) è stato 15.

Conclusioni

La riduzione cruenta e la sintesi interna delle fratture del capitello radiale mostrano risultati più che soddisfacenti, ovviamente con i migliori recuperi nelle fratture meno complesse tipo Mason II.

Abstract

Abstract

The important stabilizing role of the radial head makes its reconstruction by open reduction and internal fixation, when possible, the treatment of choice for these fractures.

Purpose

Medium-term evaluation of open reduction and internal fixation in radial head fractures.

Methods

Nineteen patients with radial head fractures treated with open reduction and internal fixation between 2006 and 2010 (11 Mason II, 5 Mason III and 3 Mason IV) were retrospectively examined with a mean follow-up of 33 months from the intervention. We used plates and free screws in 9 cases, free cannulated screws in 8 cases, k-wire and plate in one case and only plate in one case.

Results

Flexion averaged 129,2o, the mean extension deficit was 7,9o, pronation 60o and supination 53,4o. On the Mayo Elbow Performace Score, 12 patients achieved excellent results, 1 good, 4 fair and 2 poor. The mean DASH Score was 15.

Conclusions

Open reduction and internal fixation show good results, specially for Mason II radial head fractures.

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Bibliografia

  1. Ring D (2008) Fratture e lussazioni del gomito. In: Rockwood e Green. Traumatologia dell’adulto. Verduci, Roma, pp. 991–1050

    Google Scholar 

  2. Morrey BF (2000) Biomechanics of the elbow. In: Morrey BF (Ed) The elbow and its disorders. W.B. Saunders, Philadelphia, PA, pp. 43–60

    Google Scholar 

  3. Morrey BF, Tanaka S, An KN (1991) Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop 265:187–195

    PubMed  Google Scholar 

  4. Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815

    PubMed  Google Scholar 

  5. Quintero J (2000) Olecranon/radial head/complex elbow injuries. In: Ruedi TP, Murphy WM (Eds) AO Principles of fracture management. Thieme Stuttgart, New York, pp 323–339

    Google Scholar 

  6. Smith GR, Hotchkiss RN (1996) Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. J Shoulder Elbow Surg 5:113–117

    Article  PubMed  CAS  Google Scholar 

  7. Caputo AE, Mazzocca AD, Santoro VM (1998) The nonarticulating portion of the radial head: anatomic and clinical correlations for internal fixation. J Hand Surg Am 23:1082–1090

    Article  PubMed  CAS  Google Scholar 

  8. Morrey BF, An KN, Chao EY (2000) Functional evaluation of the elbow. In: Morrey BF (Ed) The elbow and its disorders. W.B. Saunders, Philadelphia, PA, pp. 74–83

    Google Scholar 

  9. Longo UG, Franceschi F, Loppini M et al (2008) Rating systems for evaluation of the elbow. Br Med Bull 87:131–161

    Article  PubMed  Google Scholar 

  10. Morrey BF (2000) Radial head fractures. In: Morrey BF (Ed) The elbow and its disorders. W.B. Saunders, Philadelphia, PA, pp. 341–363

    Google Scholar 

  11. Lindenhovius AL, Felsch Q, Doornberg JN et al (2007) Open reduction and internal fixation compared with excision for unstable displaced fractures of the radial head. J Hand Surg Am 32:630–636

    Article  PubMed  Google Scholar 

  12. Ring D (2011) Radial head fracture: open reduction-internal fixation or prosthetic replacement. J Shoulder Elbow Surg 20[2 Suppl.]:107–112

    Article  Google Scholar 

  13. Ring D (2008) Displaced, unstable fractures of the radial head: fixation vs. replacement — What is the evidence? Injury 39:1329–1337

    Article  PubMed  Google Scholar 

  14. Iftimie PP, Calmet Garcia J, de Loyola Garcia Forcada I et al (2011) Resection arthroplasty for radial head fractures: Longterm follow-up. J Shoulder Elbow Surg 20:45–50

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Università degli Studi di Torino, Torino, Italy

    S. Vanni & A. Martinasso

  2. U.O.C. Traumatologia Muscolo-Scheletrica, CTO Torino, Via Zuretti 29, 10100, Torino, Italy

    R. Matteotti, P. Tos & B. Battiston

  3. Presidio Sanitario Gradenigo, Torino, Italy

    F. Mosetto

Authors
  1. S. Vanni
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  2. R. Matteotti
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  3. A. Martinasso
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  4. F. Mosetto
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  5. P. Tos
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  6. B. Battiston
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Corresponding author

Correspondence to R. Matteotti.

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Vanni, S., Matteotti, R., Martinasso, A. et al. Riduzione e osteosintesi delle fratture del capitello radiale: indicazioni e tecnica chirurgica. Aggiornamenti 18, 39–44 (2012). https://doi.org/10.1007/s10351-012-0006-0

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  • DOI: https://doi.org/10.1007/s10351-012-0006-0

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