Elbow Arthroscopy for the Treatment of Radial Head Fractures: Surgical Technique and 10 Years of Follow Up Results Compared to Open Surgery.

BACKGROUND: This study aimed to describe the ARIF (Arthroscopic Reduction Internal Fixation) technique for radial head fractures and to compare the results with ORIF (Open Reduction Internal Fixation) at mean 10 years. METHODS: A total of 32 patients affected by Mason II or III fractures of the radial head who underwent ARIF or ORIF by screws fixation were retrospectively selected and evaluated. A total of 13 patients were treated (40.6%) by ARIF and 19 patients (59.4%) by ORIF. Mean follow-up was 10 years (7-15 years). All patients underwent MEPI and BMRS scores at follow-up, and statistical analysis was performed. RESULTS: No statistical significance was reported in Surgical Time (p = 0.805) or BMRS (p = 0.181) values. Significative improvement was recorded in MEPI score (p = 0.036), and between ARIF (98.07, SD ± 4.34) and ORIF (91.57, SD ± 11.67). The ARIF group showed lower incidence of postoperative complications, especially regarding stiffness (15.4% with ORIF at 21.1%). CONCLUSIONS: The radial head ARIF surgical technique represents a reproducible and safe procedure. A long learning curve is required, but with proper experience, it represents a tool that might be beneficial for patients, as it allows a radial head fracture to be treated with minimal tissue damage, evaluation and treatment of the concomitant lesions, and with no limitation of the positioning of screws.

Reproducibility of the Tronzo and AO classifications for transtrochanteric fractures.

OBJECTIVE: To analyze the reproducibility of the Tronzo and AO classifications for transtrochanteric fractures. METHOD: This was a cross-sectional study in which the intraobserver and interobserver concordance between two readings made by 11 observers was analyzed. The analysis of the variations used the kappa statistical method. RESULTS: Moderate concordance was found in relation to the AO classification, while slight concordance was found for the Tronzo classification. CONCLUSION: This study found that the AO/Asif classification for transtrochanteric presented greater intra and interobserver reproducibility and that greater concordance was correlated with greater experience of the observers. Without division into subgroups, the AO/Asif classification was shown, as described in the literature, to be acceptable for clinical use in relation to transtrochanteric fractures of the femur, although it did not show absolute concordance, given that its concordance level was only moderate. Nonetheless, its concordance was better than that of the Tronzo classification.

OBJETIVO: Analisar a reprodutibilidade das classificações AO e de Tronzo para fraturas transtrocanterianas. MÉTODO: Estudo transversal que analisou a concordância entre duas leituras feitas por 11 observadores, intraobservadores e interobservadores. A análise das variações usou o método estatístico Kappa. RESULTADOS: Verificou-se concordância moderada para a classificação AO enquanto a classificação Tronzo mostrou concordância leve. CONCLUSÃO: O trabalho evidenciou maior reprodutibilidade da classificação AO/Asif inter e intraobservador para as fraturas transtrocanterianas de fêmur, o que tem relação com o aumento da predominância de concordância com a experiência dos observadores. A classificação AO/Asif sem divisão em subgrupos mostrou-se, assim como descrito na literatura, aceita para o uso clínico nas fraturas transtrocanterianas de fêmur. No entanto, não mostrou concordância absoluta, uma vez que seu nível de concordância é apenas moderado, mas superior quando comparada com a classificação Tronzo.

Reprodutibilidade das classificações de Tronzo e AO para fraturas transtrocanterianas / Reproducibility of the Tronzo and AO classifications for transtrochanteric fractures

Analisar a reprodutibilidade das classificações AO e de Tronzo para fraturas transtrocanterianas. Método: Estudo transversal que analisou a concordância entre duas leituras feitas por 11 observadores, intraobservadores e interobservadores. A análise das variações usou o método estatístico Kappa. Resultados: Verificou-se concordância moderada para a classificação AO enquanto a classificação Tronzo mostrou concordância leve. Conclusão: O trabalho evidenciou maior reprodutibilidade da classificação AO/Asif inter e intraobservador para as fraturas transtrocanterianas de fêmur, o que tem relação com o aumento da predominância de concordância com a experiência dos observadores. A classificação AO/Asif sem divisão em subgrupos mostrou-se, assim como descrito na lite ratura, aceita para o uso clínico nas fraturas transtrocanterianas de fêmur. No entanto, não mostrou concordância absoluta, uma vez que seu nível de concordância é apenas moderado, mas superior quando comparada com a classificação Tronzo.

To analyze the reproducibility of the Tronzo and AO classifications for transtrochanteric fractures. METHOD: This was a cross-sectional study in which the intraobserver and interobserver concordance between two readings made by 11 observers was analyzed. The analysis of the variations used the kappa statistical method. RESULTS: Moderate concordance was found in relation to the AO classification, while slight concordanc was found for the Tronzo classification. CONCLUSION: This study found that the AO/Asif classification for transtrochanteric presented greater intra and interobserver reproducibility and that greater concordance was correlated with greater experience of the observers. Without division into subgroups, the AO/Asif classification was shown, as described in the literature, to be acceptable for clinical use in relation to transtrochanteric fractures of the femur, although it did not show absolute concordance, given that its concordance level was only moderate. Nonetheless, its concordance was better than that of the Tronzo classification.