Mid-to Long-term Outcomes of Headless Compression Screws Versus Anatomical Plate Fixation for Radial Head and Neck Fractures With≤3 Fragments
10.3969/j.issn.1009-6604.2025.06.003
- VernacularTitle:无头加压螺钉和解剖钢板内固定治疗骨折块≤3块的桡骨头颈骨折的中长期疗效比较
- Author:
Yuliang FU
1
;
Yuan CAO
1
;
Zengzhen CUI
1
;
Liangyu BAI
1
;
Yang LYU
1
Author Information
1. 北京大学第三医院骨科 骨与关节精准医学教育部工程研究中心,北京 100191
- Publication Type:Journal Article
- Keywords:
Radial head fracture;
Screw;
Plate;
Internal fixation
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(6):335-341
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the mid-to long-term clinical outcomes between screw and plate fixation for radial head and neck fractures with ≤ 3 fragments.Methods This retrospective study included 70 cases of comminuted radial head and neck fractures treated between January 2013 and December 2022.Fracture patterns included 44 cases with 2 fragments and 26 cases with 3 fragments.Patients were divided into screw fixation group(n=31,headless compression screws)and plate fixation group(n=39,anatomic plate).A comparison was conducted in the Mayo Elbow Performance Score(MEPS),range of motion of the elbow and forearm,complications,and reasons for re-operation.Results One case in each of the two groups required radial head arthroplasty due to non-union of the fracture(failure of internal fixation),while the remaining 68 cases met the criteria of fracture union.Follow-up duration ranged for 20-135 months(mean,66.7 months).Among them,14 cases were less than 36 months,18 cases were between 36-60 months,and 36 cases were over 60 months.At the last follow-up,the MEPS score was 85-100 points,with a median of 100 points,and there was no significant difference between the two groups(P=0.762).The screw fixation group demonstrated superior supination to the plate fixation group(78.5°±5.0° vs.76.2°±4.6°,t=2.010,P=0.049),while flexion,extension,and pronation showed comparable outcomes between the two groups(P＞0.05).Compared to the plate fixation group,the screw fixation group had significantly lower overall complication rates[12.9％(4/31)vs.46.2％(18/39),P=0.003],reduced re-operation rate[6.5％(2/31)vs.30.8％(12/39),P=0.012]and re-operation rate due to hardware irritation[3.3％(1/31)vs.25.6％(10/39),P=0.026].Conclusions Both fixation methods provide satisfactory outcomes for radial head and neck fractures with 3 fragments.Screw fixation demonstrates a reduced postoperative reoperation rate.
