Journal of Pain Research (Oct 2022)

Comparative Study Between the Mini-Open (≤2.5 Cm) Approach and Conventional Open Lateral Approach in the Surgical Treatment of Radial Head Fractures

  • Zhou X,
  • Wang B,
  • Liu Y,
  • Wang Z,
  • Zhao X,
  • Liu F,
  • Lu S,
  • Xu W,
  • Li L,
  • Dong J

Journal volume & issue
Vol. Volume 15
pp. 3413 – 3422

Abstract

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Xiaofeng Zhou,1 Bingzhi Wang,2 Yu Liu,1 Zicheng Wang,2 Xuehui Zhao,2 Fanxiao Liu,2 Shun Lu,2 Weicheng Xu,2 Lianxin Li,1,2 Jinlei Dong2 1Department of Orthopaedics Surgery, Shandong Provincial Hospital, Shandong University, Jinan, People’s Republic of China; 2Department of Orthopaedics Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of ChinaCorrespondence: Lianxin Li, Department of Orthopaedics, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, People’s Republic of China, Tel +8613505312449, Email [email protected] Jinlei Dong, Department of Orthopaedics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China, Tel +861509874540, Email [email protected]: The conventional lateral approach is widely used to treat radial head fractures with screws. However, the traditional incision may have shortcomings, including excessive exposure and significant scarring. We propose an innovative method – a mini-open lateral approach of less than 2.5 cm for surgical treatment of radial head fractures with screws.Methods: From Jan 2017 to Dec 2020, 34 patients diagnosed with closed radial head fracture were treated with open reduction and internal fixation (ORIF) in this study. The novel group (mini-open group) included 15 patients, and the other 19 patients were in the traditional group. The time of operation and the blood loss during operation were recorded. Postoperative clinical outcomes and radiographic results were recorded and compared between the two groups. The range of motion (ROM) in the elbow, the Visual Analogue Scale (VAS), the Mayo Elbow Performance Score (MEPS), Rating Scale of the American Shoulder and Elbow Surgeons (ASES), and the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Q-DASH) score and complications, such as wound infection, vascular and nerve damage, and fragment redisplacement were observed in the two groups.Results: In the comparison between the two groups, there was no significant difference in age, sex, cause of radial head fracture, or other basic information. The operation time, intraoperative blood loss, and VAS score at 3 days postoperation were significantly reduced in the novel group (p < 0.05). The follow-up results showed that there was no significant difference in MEPS, ASES, or Q-DASH scores between the two groups.Conclusion: The mini-open approach reduced intraoperative blood loss, shortened operation time, relieved patient pain, and achieved a satisfactory postoperative clinical result, which demonstrates that the novel approach is a safe and effective option for treating radial head fractures.Keywords: radial head, mini-open, fracture, screw, clinical efficacy

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