Essex-Lopresti injuries are often unrecognized acutely with resulting debilitating adverse effects. Persistent axial forearm instability may affect load transmission at both the elbow and wrist, resulting in significant pain. In the setting of both acute and chronic injuries metallic
Background. Comminuted radial head fractures are challenging to treat with open reduction and internal fixation. Complicating matters further, radial head fractures are often associated with other elbow fractures and soft tissue injuries.
INTRODUCTION:.
Background.
To study the surgical outcome of multi-fragmentary, un-reconstructable radial head fractures managed acutely by a radial head prosthetic replacement, we retrospectively reviewed nineteen radial head fractures that were treated acutely with a
The clinical case refers to a male patient, 34 years old, admitted at the Emergency Department after a fall of 2 meters. Of that trauma, resulted an exposed Monteggia fracture type III – Gustillo & Anderson IIA – on his left arm. With this work, the authors intend to describe the evolution of the patient's clinical condition, as well as the surgical procedures he was submitted to. The authors used the patient's records from Hospital's archives, namely from the Emergency Department, Operating Room, Infirmary and Consultation, and also the diagnostic exams performed throughout the patient's clinical evolution. The clinical case began in December 2011, when the patient suffered a fall of 2 meters in his workplace. From the evaluation in the Emergency Department, it was concluded that the patient presented, at the left forearm, an exposed Monteggia type III fracture – Gustillo & Anderson IIA – combined with a comminuted fracture of the radial head. At the admission day, the wound site was thoroughly rinsed, the fracture was reduced and immobilized with an above-the-elbow cast, and antibiotics were initiated. Six days after admission, the patient was submitted to open reduction with internal fixation with plate and screws of the fracture of the ulna and
Purpose. Limited information is available regarding the functional outcomes of radial head fractures managed with open reduction and internal fixation (ORIF). The purpose of this study was to determine the functional outcomes of radial head fractures treated with ORIF. Method. Fifty-two patients, with a mean age of 4412 years, who were treated with radial head ORIF were evaluated at a mean of 4.42.4 years. Thirty were isolated radial head fractures (Group A), 13 (Group B) were associated with a complex fracture-dislocation (terrible triad variants), and 5 (Group C) were associated with a proximal ulnar fracture (Monteggia/trans-olecranon variants). Fourty-four were partial articular fractures and 8 were complete articular fractures. Outcomes were assessed with physical and radiographic examination, and validated self-reported questionnaires. Results. The average PREE score (Patient Rated Elbow Evaluation) for Groups A, B, and C were 7.613.1, 12.313.4, and 108.5, respectively. The average MEPI (Mayo Elbow Performance Score) for Groups A, B, and C were 8913, 8511, and 918, respectively. For Groups A, B, and C respectively, the prevalence of radiographic radiocapitellar arthritis was 30%, 46%, and 20%. The average flexion/extension arc for Groups A, B, and C were 7 to 132, 6 to 134, and 10 to 132 respectively. Secondary surgery was performed in 17% of cases, most commonly for decreased motion. Three comminuted fractures failed ORIF and required conversion to