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Clinical Results of Surgical Treatment for Comminuted Radial Head and Neck Fracture: Headless Compression Screws Versus Plate Fixation

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Abstract

Background

We surgically treated comminuted radial head and neck fractures using headless compression screws, including multiple screws for the radial head and a single oblique screw for the radial neck. This study aimed to compare the clinical and radiological results for comminuted radial head and neck fractures between surgery using headless compression screws with a single oblique screw for the radial neck, our new procedure, and a plate system precontoured to the proximal radius.

Methods

This retrospective study included 23 patients (11 and 12 in the screw and plate groups, respectively). The fractures were type 3 according to the Mason–Johnston classification modified by Broberg and Morrey. Clinical outcomes analyzed included the motion range of the elbow and forearm, Mayo Elbow Performance Score, and radiological assessments. In addition, postoperative complications were also investigated. The average follow-up was 18 months.

Results

The bone union was achieved in all the patients, and there were no significant differences in clinical outcomes and radiological assessments except forearm supination (p = 0.02). Furthermore, additional surgical procedures were performed in one and five patients in the screw and plate groups, respectively (p = 0.16). Posterior nerve palsy was observed in two patients in the plate group. Complications were observed in one and six patients in the screw and plate groups, respectively (p = 0.07).

Conclusion

Both surgical procedures achieved good clinical and radiological outcomes with bone and ligament injury repair. The screw group had a greater range of forearm supination than the plate group.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to ethical restrictions.

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Acknowledgements

We would like to thank Honyaku Center Inc. for English language editing.

Funding

Nothing to declare.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seikeikai Hospital, 1-1-1 Minamiyasuicho, Sakai-Ku, Sakai City, Osaka, 590-0064, Japan

    Koichi Yano, Yasunori Kaneshiro, Ryo Sasaki & Takeshi Matsuura

  2. Department of Orthopaedic Surgery, Baba Memorial Hospital, 4-244 Hamaderahunaocho, Nishi-Ku, Sakai City, Osaka, 592-8341, Japan

    Makoto Fukuda

  3. Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-Ku, Osaka, 545-0053, Japan

    Takuya Uemura

  4. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-Ku, Osaka, 534-0021, Japan

    Kiyotaka Yamanaka

  5. Department of Orthopaedic Surgery, Higashisumiyoshi Morimoto Hospital, 3-2-66 Takaai, Higashisumiyoshi-Ku, Osaka, 546-0014, Japan

    Hidetoshi Teraura

  6. Department of Orthopaedic Surgery, Ishikiri Seiki Hospital, 18-28 Yayoicho, Higashiosaka City, Osaka, 579-8026, Japan

    Ken Yamamoto

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  1. Koichi Yano
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Correspondence to Koichi Yano.

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Yano, K., Fukuda, M., Uemura, T. et al. Clinical Results of Surgical Treatment for Comminuted Radial Head and Neck Fracture: Headless Compression Screws Versus Plate Fixation. JOIO 57, 253–261 (2023). https://doi.org/10.1007/s43465-022-00792-4

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  • DOI: https://doi.org/10.1007/s43465-022-00792-4

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