Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis

被引:23
作者
Sun H. [1 ]
Duan J. [1 ]
Li F. [1 ]
机构
[1] Department of Orthopedics, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of JiNan University, 396 Tong Fu Zhong Road, Guangzhou, 510220, Guangdong
关键词
Meta-analysis; Radial head arthroplasty; Radial head fixation; Radial head fracture; Terrible triad injuries;
D O I
10.1007/s00590-016-1739-1
中图分类号
学科分类号
摘要
Purpose: Open reduction and internal fixation (ORIF) and radial head arthroplasty (RHA) are the most common operative treatments in patients with radial head fractures. The purpose of this study was to determine the efficacy of RHA and ORIF treatments in patients with radial head fractures (modified Mason type III and IV). Methods: We conducted a computerized search of five electronic databases from their inception to July 2015. All clinical trials comparing ORIF versus RHA treatment in patients with radial head fractures were included. We evaluated the primary outcomes included elbow functional evaluation criteria by Broberg and Morrey, elbow score (Broberg and Morrey), Mayo Elbow Performance Score (MEPS) and QuickDASH score. Secondary outcomes included Visual Analog Scale (VAS), range of motion, operation time and complications. The “assessing risk of bias” table was applied to assess the risk of bias of the included studies. Result: Eight studies were included in this meta-analysis, which consisted of 138 cases of ORIF and 181 RHA. Methodological quality of the studies was moderate to low. RHA afforded significantly higher satisfaction rate, better elbow score (Broberg and Morrey) and MEPS, shorter operation time, lower incidence of bone nonunion or absorption and internal fixation failure when compared to ORIF. There were no significantly differences in QuickDASH score and other complications. Conclusions: RHA has better outcome in patients with radial head fractures (modified Mason type III and IV) than ORIF with medium-short-term follow-up period, but longer-term studies will be required to ascertain whether the apparent benefits of RHA were offset by late complications. Level of evidence: Therapeutic decision analysis; a meta-analysis, Level III. © 2016, Springer-Verlag France.
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页码:283 / 291
页数:8
相关论文
共 24 条
[1]  
Duckworth A.D., Clement N.D., Jenkins P.J., Aitken S.A., Court-Brown C.M., McQueen M.M., The epidemiology of radial head and neck fractures, J Hand Surg Am, 37, 5, pp. 112-119, (2012)
[2]  
Kaas L., van Riet R.P., Vroemen J.P., Eygendaal D., The epidemiology of radial head fractures, J Shoulder Elbow Surg, 19, 6, pp. 520-523, (2010)
[3]  
Kaas L., Struijs P.A., Ring D., van Dijk C.N., Eygendaal D., Treatment of Mason type II radial head fractures without associated fractures or elbow dislocation: a systematic review, J Hand Surg Am, 37, 1, pp. 1416-1421, (2012)
[4]  
Bruinsma W., Kodde I., de Muinck Keizer R.J., Kloen P., Lindenhovius A.L., Vroemen J.P., A randomized controlled trial of nonoperative treatment versus open reduction and internal fixation for stable, displaced, partial articular fractures of the radial head: the RAMBO trial, BMC Musculoskelet Disord, 6, 15, pp. 140-147, (2014)
[5]  
Delclaux S., Lebon J., Faraud A., Toulemonde J., Bonnevialle N., Coulet B., Complications of radial head prostheses, Int Orthop, 39, 7, pp. 907-913, (2015)
[6]  
Hall J.A., McKee M.D., Posterolateral rotatory instability of the elbow following radial head resection, J Bone Joint Surg Am, 8, 3, pp. 1571-1579, (2008)
[7]  
Allieu Y., Winter M., Pequignot J.P., Radial head replacement with a pyrocarbon head prosthesis: preliminary results of a multicentric prospective study, Eur J Orthop Surg Traumatol, 16, 1, pp. 1-9, (2006)
[8]  
Ring D., Open reduction and internal fixation of fractures of the radial head, Hand Clin, 20, 4, pp. 415-427, (2004)
[9]  
Ring D., Radial head fracture: open reduction-internal fixation or prosthetic replacement, J Shoulder Elbow Surg, 20, 8, pp. 107-112, (2011)
[10]  
Li N., Chen S., Open reduction and internal-fixation versus radial head replacement in treatment of Mason type III radial head fractures, Eur J Orthop Surg Traumatol, 24, 6, pp. 851-855, (2014)