A retrospective study of arthroscopic versus open radial head plasty for the treatment of elbow stiffness due to radial head fracture
Objective To investigate and compare the therapeutic effects of arthroscopic and open surgery on elbow joint stiffness caused by radial head fractures.Methods A retrospective analysis was conducted on patients with elbow stiffness in the elbow joint surgical treatment group of our hospital from January 2020 to January 2022.Patients with skeletal obstruction of the radial head due to complications such as radial head malunion and ectopic ossification after conservative or surgical treatment of radial head fractures were selected.Collect perioperative data from patients,including surgical methods,modified Mason classification of radial head fractures,preoperative and postoperative pain VAS scores,elbow flexion extension and rotation range of motion,Mayo elbow performance score(MEPS)scores,postoperative complications,and secondary surgery rate,and compare the efficacy of arthroscopy and open radial head arthroplasty surgery.Results A total of 47 patients were included and divided into an open group(26 cases)and an arthroscopic group(21 cases)according to different treatment methods.There were 29 males and 18 females with an average age of(34.70±7.90)years and an average follow-up time of(15.19±3.86)months.There were 10 cases of Mason type Ⅰ,20 cases of Mason type Ⅱ,and 17 cases of Mason type Ⅱ.The elbow joint range of motion,VAS score,and MEPS score of both groups of patients showed significant improvement during the final follow-up,with no statistically significant difference(P>0.05).The flexion and extension range of motion(124.38±8.25)° in the arthroscopic group was significantly higher than that in the open group(115.92±8.38)° 6 weeks after surgery.On the second day and 6 weeks after surgery,the VAS scores in the arthroscopic group were significantly lower than those in the open group[(4.48±1.12)vs.(5.88±1.14),(3.48±1.08)vs.(4.19±1.90)],and the differences were statistically significant(P<0.05).No complications such as infection,joint instability,secondary joint stiffness,or ectopic ossification were found in the arthroscopic group,while 2 cases of ectopic ossification were observed in the open group,with 1 case of significant joint stiffness requiring secondary surgical treatment.Conclusions Both open and elbow arthroscopic radial head arthroplasty can treat joint stiffness caused by radial head fractures and achieve satisfactory results.Elbow arthroscopy has the advantages of minimal trauma,good wound appearance,and fast recovery.
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