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Acute Radial Head Resection for Fracture: are We Likely to Miss an Essex-Lopresti Injury?

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Zhang D., Benavent K. A., Dyer G. S. M., Earp B. E., Blazar P.

Ortopedia Traumatologia Rehabilitacja

2021

vol. 23(4)

263-270

Background. Given the current available evidence, surgical treatment of radial head fracture with acute resection is controversial. The aim of this study was to determine whether acute resection of the radial head for a radial head fracture leads to longitudinal forearm instability due to a missed Essex-Lopresti injury. Material and methods. A retrospective review was conducted of radial head resections performed for acute radial head fractures at two Level I trauma centers from 2000 to 2018. A total of 11 patients met inclusion criteria. Our primary outcome was a missed Essex-Lopresti injury at time of final clinical follow-up. Long-term telephone follow-up was attempted for QuickDASH, pain scores, and satisfaction scores. Results. Of the 11 radial head fractures in this study, intraoperative radial pull tests were performed and normal in 6 patients. No patient was found to have a missed Essex-Lopresti injury at a mean of 36.2 months’ clinical follow-up after radial head resection. At a mean telephone follow-up of 12.6 years in available patients, mean QuickDASH was 3.4, mean satisfaction was 9.75 out of 10, and no further complication or reoperation was reported. Conclusion. Our findings challenge the dogma that the radial head cannot be safely excised in the setting of acute fracture, even with elbow instability and/or wrist pain, particularly when intraoperative longitudinal stability is assessed by a stress maneuver.

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1 Ortopedia Traumatologia Rehabilitacja

1 2021

1 Benavent K. A.

1 Blazar P.

1 Dyer G. S. M.

1 Earp B. E.

1 Zhang D.

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Acute Radial Head Resection for Fracture: are We Likely to Miss an Essex-Lopresti Injury?