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. 2021 Apr;105(1):17-29.
doi: 10.1007/s12306-020-00679-3. Epub 2020 Oct 7.

Clinical outcomes after internal fixation, arthroplasty and resection for treatment of comminuted radial head fractures: a systematic review and network meta-analysis

K Chaijenkij  1 , A Arirachakaran  2 , J Kongtharvonskul  3
Affiliations

Clinical outcomes after internal fixation, arthroplasty and resection for treatment of comminuted radial head fractures: a systematic review and network meta-analysis

K Chaijenkij et al. Musculoskelet Surg. 2021 Apr.

Abstract

Background: Radial head fractures make up approximately 3% of all fractures, and they are the most common elbow fracture in adults. The treatment for comminuted radial head fracture remains controversial. This systematic review was conducted with the aim to compare postoperative outcomes among surgical treatments to identify which method is the best for comminuted radial head fractures.

Methods: Relevant studies were identified from Medline and Scopus from inception to February 22, 2020, that reported Mayo Elbow Performance Index (MEPI) score and postoperative complications of either treatment. A network meta-analysis was applied to assess treatment outcomes. Probability of being the best treatment was estimated using surface under the cumulative ranking curves (SUCRA).

Results: Twelve comparative studies and one randomized controlled trial (N = 526 patients) met the inclusion criteria. Interventions included open reduction and internal fixation (ORIF) (N = 210 patient), radial head arthroplasty (RHA) (N = 227 patients) and radial head resection (RHR) (N = 152 patients). A network meta-analysis showed that the MEPI of RHA was significantly higher when compared to ORIF and RHR, with a pooled mean MEPI of 7.28 (1.69, 12.86) and - 7.32 (- 13.21, - 1.43), respectively. In terms of complications, RHA and RHR had lower risk with RRs of 0.61 (0.29, 1.31) and 0.54 (0.24, 1.25) when compared to ORIF. The SUCRA probabilities of RHA and RHR were in the first rank with 99.2% in MEPI and 60.6% in complications, respectively.

Conclusions: This study suggests that RHA is the best treatment of choice for efficacy and safety in the treatment of comminuted radial head fracture, while RHR is the safest choice to minimize postoperative complications and enable patients to perform all daily life activities.

Keywords: Arthroplasty; Comminuted radial head fracture; Open reduction and internal fixation; Resection.

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References

    1. Kovar FM, Jaindl M, Thalhammer G, Rupert S, Platzer P, Endler G et al (2013) Incidence and analysis of radial head and neck fractures. World J orthop 4(2):80–84 - PubMed - PMC
    1. Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM (2012) The epidemiology of radial head and neck fractures. The Journal of hand surgery. 37(1):112–119 - PubMed
    1. Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42(172):123–132 - PubMed
    1. Johnston GW (1962) A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulst Med J 31:51–56
    1. Yu W, Hu J, Zhang X, Zhu X, Xu Y, Yi J et al (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. Ther Clin Risk Manag 12:825–830 - PubMed - PMC

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