Surgical therapy of radial head fractures combined with ulnar collateral ligament injuries / 中华创伤杂志

ABSTRACT

ObjectiveTo analyze treatment methods for radial head fractures combined with ulnar collateral ligament injuries and discuss the related effects.MethodsA total of 38 patients undergone operations for radial head fractures combined with ulnar collateral ligament injuries from August 2004to January 2011 at People' s Hospital of Peking University were followed up and 24 patients had complete follow-up data.According to the modified Mason typing,there were six patients with Mason-Johnston type Ⅱ fractures,15 with type Ⅲ and three with type Ⅳ. Conventional screws,Herbert screws,hollow screws,absorbable screws and mini-type plates were used for fracture fixation respectively.Severe communicated fractures were treated with radial head replacement and the injured collateral ligament complex with direct suture or ligament reconstruction.Results The duration of follow-up was 10-84 months (average 37.1 months).According to the Mayo Elbow-Performance Score,the results were excellent in 18 patients,good in four and fair in two,with excellence rate of 92％.ConclusionsFor the radial head fractures combined with ulnar collateral ligament injuries (severer than Mason type Ⅱ ),the first choice should be radial head reconstruction.If the fractures cannot be reconstructed,the radial head replacement is the best choice.If there still exists the elbow valgus instability after radial head reconstruction,the ulnar collateral ligament should be repaired or constructed.Primary repair and reconstruction of the radial and ulnar collateral ligaments is necessary when the radial head replacement is performed.