Risk factors of elbow joint rotation dysfunction after radial head surgeries
Cui Kui
Tan Jie
Shi Changhao
Gong Maoqi
Abstract：Objective To investigate the risk factors associated with elbow rotation dysfunction after radial head surgery.Methods This retrospective analysis was performed on 82 patients admitted to the Department of Traumatic Orthopedics,Beijing Jishuitan Hospital,Capital Medical University,undergoing surgical treatment for ra-dial head fractures from Jan.2023 to Dec.2023,including 45 males and 37 females.The age ranged from 20 to 83 years,mean 43.9 years.Among them,43 cases involved the right side and 39 the left;28 were high energy injuries and 54 were low energy;46 were of Mason type Ⅱ,21 of type Ⅲ and 15 of type Ⅳ;25 were open fractures and 57 were closed.Patients were divided into rotation dysfunction group and non-rotation dysfunction group according to whether the range of motion of the elbow joint was＞100° at 6 months after surgery and longer.The correlation of age,gender,body mass index(BMI),injury side,Mason classification,reduction quality,injury mechanism,soft tis-sue status(open or closed)at the time of injury,surgical method,time from injury to surgical treatment,postoperative immobilizaton time,and use of anti-heterotopic ossification drugs were analyzed.Results There were 20 patients in the rotation dysfunction group and 62 in the non-rotation dysfunction group.Univariate analysis showed that the rota-tion dysfunction group had significantly higher proportions of patients with unsatisfied reduction(35.0％vs.17.8％),high-energy damage(60.0％vs.25.8％),open fractures(70.0％vs.17.7％),Mason type Ⅲ(30.0％vs.24.2％)and Ⅳ(30.0％vs.14.5％),injury to surgery time＞7 d(70.0％vs.22.6％),postoperative immobilizaton time＞2 weeks(60.0％vs.32.3％),and no use of anti-heterotopic ossification drugs(70.0％vs.17.7％),all re-vealing significant difference compared with the non-rotation dysfunction group(all P＜0.05).Multiariable logistic regression analysis showed that Mason type Ⅲ and Ⅳ radial head fractures(OR=3.471,95％CI=1.333-9.037),unsatisfied reduction(OR=3.457,95％CI=1.386-8.622),high-energy injuries(OR=2.223,95％CI=1.435-9.227),open fractures(OR=3.368,95％CI=1.403-8.702),injury to operating time＞7 d(OR=3.546,95％CI=1.641-9.032),and postoperative immobilizaton time＞2 weeks(OR=3.271,95％CI=1.373-7.746)were inde-pendent risk factors for radial head elbow rotation dysfunctions after surgical management.Conclusion For patients with radial head fractures,those of Mason type Ⅲ/Ⅳ or with poor reduction quality,high-energy injury,open frac-ture,time from injury to surgery＞7 d,or postoperative immobilizaton time＞2 weeks have a higher risk of elbow rota-tion dysfunction and should be paid more attention to.
Keywords：Radial head fracturesRotation dysfunctionRisk factors
Publication Date：2024-11-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 830-835 )