Frequency of occurrence
Recently, the number of injuries with fractures and dislocations of the forearm bones has increased significantly. One of the reasons for this increase is an increase in the number of victims of road accidents, an increase in the number of catatrauma and other high-energy injuries (for example, in athletes).
According to the literature, fractures and dislocations of the forearm bones account for approximately 1-2% of all forearm injuries. A fracture of the radial head, in turn, accounts for up to 20% of all injuries to the elbow joint, and in half of cases it is combined with damage to other structures of the elbow joint.
About 10% of fractures in this area are accompanied by dislocations of the forearm bones in the elbow joint.
Mechanogenesis of damage
Fracture of the head of the radius (according to ICD-10: S52. 1 Fracture of the upper end of the radius) is a high-energy injury, more common in men. Such a fracture often occurs as a result of falling on an outstretched upper limb with pronation of the forearm. An axial load is applied to the radiohumeral joint, and the head of the radial bone ‘collides’ with the humerus, which leads to a fracture.
A clinical case
Possibilities of modern treatment of patients with multi-comminuted fracture of the radial head
Shuginov A. A., Nikitin A.V.
Patient I., 39 years old, suffered an elbow joint injury while roller skating, falling on her outstretched arm. Independently applied to the emergency department of the city hospital 40. Upon admission, an X-ray examination was performed (fig. 1).
Plaster immobilization was performed in a functional position. To clarify the diagnosis and preoperative planning, the patient underwent CT examination (Fig. 2).
This fracture can be classified according to the Mason classification as Type 3, according to the AO – 21C3 classification. Taking into account the young, able-bodied age of the patient, high functional requirements, and the complexity of the fracture, endoprosthesis of the radial head was chosen as the treatment method.
During the operation, a multi-comminuted fracture of the head of the radius was revealed (Fig. 3, Fig. 4).
During the operation, a component was selected that most accurately repeats the dimensions of the own head of the radius (Fig. 5, Fig. 6).
On the control radiographs, the position of the endoprosthesis components is satisfactory (Fig. 7).
The next day after the operation, the patient is allowed passive movements in the elbow joint. Full range of motion has been achieved. After removing the stitches, the patient started her normal, everyday activities and went to work.
Thus, a rational examination, careful planning, and the use of modern techniques made it possible to achieve complete restoration of joint function as soon as possible and return the patient to his daily life without restrictions, which is the main criterion for treating any pathology.