Fractures of the radial head—the benefit of aspiration: a prospective controlled trial

doi:10.1016/0020-1383(87)90385-8

Injury

Volume 18, Issue 1, January 1987, Pages 44-47

https://doi.org/10.1016/0020-1383(87)90385-8 Get rights and content

Abstract

The clinical progress of 80 adults with fractures of the radial head was followed prospectively. Early active movement of the elbow and forearm was encouraged in all patients. Better functional results were achieved by the study group than by retrospective controls in whom active movement was delayed. Aspiration of the elbow and instillation of local anaesthetic were carried out in a randomly selected half of the patients. This afforded relief of pain in 92 per cent and made early movement more comfortable. The fracture was more common in women. Functional recovery was best in younger patients and was closely related to the severity of the fracture.

References (16)

S.R. Gaston et al.
Adult injuries of the radial head and neck
Am. J. Surg.
(1949)
J.B. Adler et al.
Radial head fractures. Is excision necessary?
J. Trauma
(1963)
O. Arner et al.
Fractures of the head and neck of the radius
Acta Chir. Scand.
(1957)
G. Bakalim
Fractures of radial head and their treatment
Acta Orthop. Scand.
(1970)
J. Charnley
J.P. Fleetcroft
Fractures of the radial head: early aspiration and mobilisation
J. Bone Joint Surg.
(1984)
O. Johansson
Capsular and ligament injuries of the elbow joint
Acta Chir. Scand.
(1962)
M.L. Mason
Some observations on fractures of the head of the radius with a review of one hundred cases
Br. J. Surg.
(1954)

There are more references available in the full text version of this article.

Cited by (53)

Simultaneous bilateral and asymmetrical fracture of the radial head in a judoka: Exceptional injury by an exceptional mechanism
2019, Science and Sports
Abbreviations Used to Describe Concurrent Injuries With Radial Head Fracture
2018, Morrey's The Elbow and Its Disorders
Neglected bilateral radial head fracture with a rare presentation: A case report
2017, Chinese Journal of Traumatology - English Edition
Citation Excerpt :
The main goals of treatment of radial head fracture include, correction of any hindrance of forearm rotation by the fracture, restoration of elbow and forearm motion by early initiation of an adequate exercise program, elbow stability, limitation of the potential for ulnohumeral and radiocapitellar arthrosis and avoidance of injury-related complications.1 Holdsworth et al11 conducted a prospective study and concluded that functional recovery was better in younger patients and was inversely related to the severity of the fracture. They showed that a delay in restoration of early active movement leads to delay in the recovery of function.
Isolated radial head fractures are rare and comprise about 2% of all fractures around the elbow. Bilateral radial head fractures are even rarer and few cases have been reported. We present a case of bilateral elbow effusion in a 28-year-old male patient. An initial diagnosis of inflammatory arthritis was made but on investigation it turned out to be a case of bilateral radial head fracture. The patient was managed conservatively with 10 days of immobilisation in above elbow slab followed by active elbow range of movement exercises. On follow-up at 6 months, the patient had near normal range of movements without pain or elbow instability.
Fractures of the proximal forearm
2016, Shoulder and Elbow Trauma and its Complications
Critical Orthopedic Skills and Procedures
2013, Emergency Medicine Clinics of North America
The effect of haematoma aspiration on intra-articular pressure and pain relief following Mason i radial head fractures
2011, Injury
Citation Excerpt :
Mason type I fractures are the non-displaced radial head fractures and are treated conservatively with early mobilisation and excellent results,6,11 while in other types, surgical intervention is usually indicated.16 The aspiration of the haematoma that accompanies Mason type I radial head fractures is advocated by several authors to achieve an analgesic effect,4,9 but available evidence is still obscure to recommend it as a routine procedure.2 The purpose of this study was to investigate the effect of haematoma aspiration on intra-articular pressure and on pain relief after Mason I radial head fractures.
The aspiration of the accompanying haematoma by Mason type I radial head fractures is advocated by several authors to achieve an analgesic effect. The purpose of this study was to investigate the effect of haematoma aspiration on intra-articular pressure and on pain relief after Mason I radial head fractures.
A total of 16 patients (10 men and six women, age 23–47 years) with an isolated Mason I radial head fracture were subjected to haematoma paracentesis. Initially, intra-articular pressure was measured by using the Stryker Intra-Compartmental Pressure Monitor System. After haematoma aspiration, a new pressure measurement without moving the needle was performed. Pain before and after haematoma aspiration was evaluated by using an analogue 10-point pain scale.
Intra-articular elbow pressure prior to haematoma aspiration varied from 49 to 120 mmHg (median, 76.5 mmHg), while following aspiration, it ranged from 9 to 25 mmHg (median, 17 mmHg). The median quantity of the aspired blood was 2.75 ml (range, 0.5–8.5 ml). Patients reported a decrease in the visual analogue score (VAS) for pain from 5.5 (4–8) before to 2.5 (1–4) after aspiration. Decrease for both pressure and pain was statistically significant (p = 0.005).
The formation of an intra-articular haematoma in the elbow joint following an undisplaced Mason I radial head fracture leads to a pronounced increase of the intra-articular pressure accompanied by intense pain for the patient. The aspiration of the haematoma results in an acute pressure decrease and an immediate patient relief.

View all citing articles on Scopus

View full text

Fractures of the radial head—the benefit of aspiration: a prospective controlled trial

Abstract

Am. J. Surg.

Radial head fractures. Is excision necessary?

J. Trauma

Fractures of the head and neck of the radius

Acta Chir. Scand.

Fractures of radial head and their treatment

Acta Orthop. Scand.

Fractures of the radial head: early aspiration and mobilisation

J. Bone Joint Surg.

Capsular and ligament injuries of the elbow joint

Acta Chir. Scand.

Some observations on fractures of the head of the radius with a review of one hundred cases

Br. J. Surg.