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Case Reports
. 2016 May 26:12:825-30.
doi: 10.2147/TCRM.S107640. eCollection 2016.

Acute unstable complex radial head and neck fractures fixed with a mini T-shaped plate in a 20-year-old man: a case report

Weiguang Yu  1 , Jun Hu  1 , Xinchao Zhang  2 , Xingfei Zhu  2 , Yinfeng Xu  1 , Jianhua Yi  1 , Yunjiang Liu  1
Affiliations
Case Reports

Acute unstable complex radial head and neck fractures fixed with a mini T-shaped plate in a 20-year-old man: a case report

Weiguang Yu et al. Ther Clin Risk Manag. .

Abstract

Acute unstable complex radial head and neck fractures in adults are seldom reported in the literature. Early recognition and appropriate management are essential to prevent long-term consequences of the loss of elbow function, forearm rotation, and chronic pain. Here, we describe an unusual case of a 20-year-old man who exhibited acute unstable complex fractures of the head and neck of the right radius without other injuries or comorbidity. An open reduction and mini T-shaped plate fixation were performed within 3 hours after injury, and the results were satisfactory. A long plaster fixation was continued for 3 weeks. A gradual mobilization was started after the removal of the plaster under the supervision of a physiotherapist. At the 12-month follow-up, no complications associated with the use of the mini T-shaped plate were noted, and the Mayo Elbow Performance Score was 97 (excellent). To our knowledge, acute unstable complex radial head and neck fractures in adults can be successfully treated with a mini T-shaped plate reconstruction technique.

Keywords: internal fixation; mini T-shaped plate; radial head; radial head replacement; unstable complex fractures.

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Figures

Figure 1
Figure 1
Anteroposterior view of the elbow on admission. Note: A and B show the displacement of the radial head fracture, respectively.
Figure 2
Figure 2
Unstable complex fractures of the head and neck of the radius treated by a mini T-shaped plate. Notes: (A) Radial-head comminuted fracture, lateral collateral ligament disruption from the point of insertion to the distal humerus, which was not associated with neural injury; (B, C) radial-head reconstruction and preliminary fixation with 1 mm Kirschner wires; (D) intraoperative radiographs showing right position of mini T-shaped plate; (E, F) fixation of the fracture with mini T-shaped plate.
Figure 3
Figure 3
Postoperative radiographs demonstrating good reduction and fixation of the comminuted fragments. Notes: (A) Lateral radiograph of the right elbow showing well-reduced articular and normal position of a mini T-shaped plate and (B) anteroposterior radiograph showing normal radiocapitellar joint and the radial-head fragment fixed with a mini T-shaped plate.
Figure 4
Figure 4
Bone union at 12 months after anatomic reduction of the intra-articular surface of the radial head and stabilization with a mini T-shaped plate. Notes: (A) Anteroposterior; (B) lateral radiographs of right elbow; and (C) removing a mini T-shaped plate at 12 months, without early fusion of the epiphysis, radial head overgrowth, or avascular necrosis.
Figure 5
Figure 5
Final follow-up 1 year after trauma. Note: At final follow-up 1 year after trauma, the patient was symptom-free and had full range of motion in the elbow joint, including flexion–extension (A, B) and supination–pronation (C, D) of the forearm.
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