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Die Behandlung von Radiusköpfchenfrakturen Typ Mason II durch perkutane Drahtreposition

Treatment of Mason type II radial head fractures by percutaneous reduction

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Zusammenfassung

Hintergrund

Die Therapie von Radiusköpfchenfrakturen des Typs Mason II wird nach wie vor kontrovers diskutiert. Wir stellen die Technik der perkutanen Reposition ohne additive Stabilisierung als Alternative zur offenen Reposition mit zusätzlicher Osteosynthese vor und präsentieren die Ergebnisse der Methode.

Material und Methode

Die Daten von 26 von 30 Patienten, welche konsekutiv bei einer Fraktur des Typs Mason II versorgt worden waren, wurden retrospektiv evaluiert. In die Analyse flossen der „Disabilities of Shoulder and Hand Score“ (DASH-Score), der „Mayo Elbow Performance Score“ (MEPS) sowie die radiologische Untersuchung ein.

Ergebnisse

Das Follow-up betrug 21 (6–47) Monate. In 22 Fällen (85%) konnte ein anatomisches Repositionsergebnis erzielt werden. Zwei Fälle (8%) zeigten einen vollständigen, 2 Fälle (8%) einen geringen Repositionsverlust. Der DASH-Score lag bei 5,6 (0–56) Punkten, der mittlere MEPS betrug 93,8 (60–100, SD). Lediglich 4 Patienten (15%) äußerten eine persistierende, subjektive Funktionseinschränkung im Sinne eines DASH-Wertes > 10.

Schlussfolgerung

Die Ergebnisse belegen die Anwendbarkeit dieses minimal-invasiven Verfahrens zur operativen Versorgung von Radiusköpfchenfrakturen Typ Mason II. Die Methode stellt damit eine sehr gute Alternative zur offenen Reposition dar.

Abstract

Background

The therapeutic algorithm for the treatment of Mason type II radial head fractures is still controversially discussed. This study describes the technique of percutaneous fracture reduction without additional internal fixation of the radial head as an alternative to open reduction and presents the results of the method.

Material and methods

The data from 26 out of 30 patients with a Mason type II radial head fracture who had been consecutively treated with percutaneous fracture reduction were evaluated retrospectively. The analysis comprised the disabilities of shoulder and hand (DASH) score, the Mayo elbow performance score (MEPS) and data from the radiological examinations.

Results

The average follow-up time was 21 months (range 6-47 months). In 22 cases (85 %) an anatomical reduction could be achieved, 2 cases (8 %) showed a complete redislocation of the fragment and 2 cases (8 %) a partial redislocation. The average DASH score was 5.6 points (range 0–56) and the average MEPS was 93.8 (range 60–100). Only 4 patients (15 %) reported persisting functional impairment with a DASH score >10.

Conclusions

The method of percutaneous reduction of radial head fractures without additional internal fixation in Mason type II fractures has been demonstrated to be a good alternative to open reduction.

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  1. Centrum für Muskuloskeletale Chirurgie, Charité Universitätsmedizin Berlin, Freie und Humboldt-Universität Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    P. Simon, F. Unterhauser, P. von Roth, G. Schmidmaier & T. Winkler

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  1. P. Simon
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  2. F. Unterhauser
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  3. P. von Roth
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  4. G. Schmidmaier
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Correspondence to P. Simon.

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Simon, P., Unterhauser, F., von Roth, P. et al. Die Behandlung von Radiusköpfchenfrakturen Typ Mason II durch perkutane Drahtreposition. Unfallchirurg 117, 341–347 (2014). https://doi.org/10.1007/s00113-012-2340-7

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  • DOI: https://doi.org/10.1007/s00113-012-2340-7

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