Clinical results after different operative treatment methods of radial head and neck fractures

a systematic review and meta-analysis of clinical outcome

J Zwingmann, M Welzel, D Dovi-Akue, H Schmal, N P Südkamp, P C Strohm

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

INTRODUCTION: There is no consensus on optimal treatment strategy for Mason type II-IV fractures. Most recommendations are based upon experts' opinion.

METHODS: An OVID-based literature search were performed to identify studies on surgical treatment of radial head and neck fracture. Specific focus was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264 patients.

RESULTS: For type II radial head and neck fractures the significant best treatment option seems to be ORIF with an overall success rate of 98% by using screws or biodegradable (polylactide) pins. ORIF with a success rate of 92% shows the best results in the treatment of type III fractures and seem to be better than resection and implantation of a prosthesis. For this fracture type the ORIF with screws (96%), biodegradable (polylactide) pins (88%) and plates (83%) showed the best results. In the treatment of type IV fractures similar results could be found with a tendency of the best results after ORIF followed by resection and implantation of a prosthesis. If a prosthesis was implanted, the primary implantation seems to be associated with a better outcome after type III (87%) and IV (82%) fractures compared to the results after a secondary implantation.

DISCUSSION: Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence.

LEVEL OF EVIDENCE: IV.

OriginalsprogEngelsk
TidsskriftInjury
Vol/bind44
Udgave nummer11
Sider (fra-til)1540-50
Antal sider11
ISSN0020-1383
DOI
StatusUdgivet - nov. 2013
Udgivet eksterntJa

Fingeraftryk

Meta-Analysis
Expert Testimony
Elbow
Prostheses and Implants
poly(lactide)

Citer dette

Zwingmann, J ; Welzel, M ; Dovi-Akue, D ; Schmal, H ; Südkamp, N P ; Strohm, P C. / Clinical results after different operative treatment methods of radial head and neck fractures : a systematic review and meta-analysis of clinical outcome. I: Injury. 2013 ; Bind 44, Nr. 11. s. 1540-50.
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title = "Clinical results after different operative treatment methods of radial head and neck fractures: a systematic review and meta-analysis of clinical outcome",
abstract = "INTRODUCTION: There is no consensus on optimal treatment strategy for Mason type II-IV fractures. Most recommendations are based upon experts' opinion.METHODS: An OVID-based literature search were performed to identify studies on surgical treatment of radial head and neck fracture. Specific focus was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264 patients.RESULTS: For type II radial head and neck fractures the significant best treatment option seems to be ORIF with an overall success rate of 98{\%} by using screws or biodegradable (polylactide) pins. ORIF with a success rate of 92{\%} shows the best results in the treatment of type III fractures and seem to be better than resection and implantation of a prosthesis. For this fracture type the ORIF with screws (96{\%}), biodegradable (polylactide) pins (88{\%}) and plates (83{\%}) showed the best results. In the treatment of type IV fractures similar results could be found with a tendency of the best results after ORIF followed by resection and implantation of a prosthesis. If a prosthesis was implanted, the primary implantation seems to be associated with a better outcome after type III (87{\%}) and IV (82{\%}) fractures compared to the results after a secondary implantation.DISCUSSION: Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence.LEVEL OF EVIDENCE: IV.",
keywords = "Arthroplasty, Replacement, Elbow Joint, Female, Fracture Fixation, Internal, Humans, Male, Radius Fractures, Range of Motion, Articular, Recovery of Function, Treatment Outcome, Journal Article, Meta-Analysis, Review",
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note = "Copyright {\circledC} 2013 Elsevier Ltd. All rights reserved.",
year = "2013",
month = "11",
doi = "10.1016/j.injury.2013.04.003",
language = "English",
volume = "44",
pages = "1540--50",
journal = "Injury",
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Clinical results after different operative treatment methods of radial head and neck fractures : a systematic review and meta-analysis of clinical outcome. / Zwingmann, J; Welzel, M; Dovi-Akue, D; Schmal, H; Südkamp, N P; Strohm, P C.

I: Injury, Bind 44, Nr. 11, 11.2013, s. 1540-50.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Clinical results after different operative treatment methods of radial head and neck fractures

T2 - a systematic review and meta-analysis of clinical outcome

AU - Zwingmann, J

AU - Welzel, M

AU - Dovi-Akue, D

AU - Schmal, H

AU - Südkamp, N P

AU - Strohm, P C

N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.

PY - 2013/11

Y1 - 2013/11

N2 - INTRODUCTION: There is no consensus on optimal treatment strategy for Mason type II-IV fractures. Most recommendations are based upon experts' opinion.METHODS: An OVID-based literature search were performed to identify studies on surgical treatment of radial head and neck fracture. Specific focus was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264 patients.RESULTS: For type II radial head and neck fractures the significant best treatment option seems to be ORIF with an overall success rate of 98% by using screws or biodegradable (polylactide) pins. ORIF with a success rate of 92% shows the best results in the treatment of type III fractures and seem to be better than resection and implantation of a prosthesis. For this fracture type the ORIF with screws (96%), biodegradable (polylactide) pins (88%) and plates (83%) showed the best results. In the treatment of type IV fractures similar results could be found with a tendency of the best results after ORIF followed by resection and implantation of a prosthesis. If a prosthesis was implanted, the primary implantation seems to be associated with a better outcome after type III (87%) and IV (82%) fractures compared to the results after a secondary implantation.DISCUSSION: Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence.LEVEL OF EVIDENCE: IV.

AB - INTRODUCTION: There is no consensus on optimal treatment strategy for Mason type II-IV fractures. Most recommendations are based upon experts' opinion.METHODS: An OVID-based literature search were performed to identify studies on surgical treatment of radial head and neck fracture. Specific focus was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264 patients.RESULTS: For type II radial head and neck fractures the significant best treatment option seems to be ORIF with an overall success rate of 98% by using screws or biodegradable (polylactide) pins. ORIF with a success rate of 92% shows the best results in the treatment of type III fractures and seem to be better than resection and implantation of a prosthesis. For this fracture type the ORIF with screws (96%), biodegradable (polylactide) pins (88%) and plates (83%) showed the best results. In the treatment of type IV fractures similar results could be found with a tendency of the best results after ORIF followed by resection and implantation of a prosthesis. If a prosthesis was implanted, the primary implantation seems to be associated with a better outcome after type III (87%) and IV (82%) fractures compared to the results after a secondary implantation.DISCUSSION: Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence.LEVEL OF EVIDENCE: IV.

KW - Arthroplasty, Replacement

KW - Elbow Joint

KW - Female

KW - Fracture Fixation, Internal

KW - Humans

KW - Male

KW - Radius Fractures

KW - Range of Motion, Articular

KW - Recovery of Function

KW - Treatment Outcome

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1016/j.injury.2013.04.003

DO - 10.1016/j.injury.2013.04.003

M3 - Journal article

VL - 44

SP - 1540

EP - 1550

JO - Injury

JF - Injury

SN - 0020-1383

IS - 11

ER -