The choice of tactics of surgical treatment of patients with fractures of the head of the radius

The OBJECTIVE was to improve the results of treatment of patients with fractures of the head of the radius by improving the algorithm for choosing a treatment method depending on the type of fracture.

METHODS AND MATERIALS. The authors presented a new classification in which all fractures of the head of the radius were divided into 7 types, each of which corresponds to the optimal treatment method. Based on the proposed classification, the algorithm for choosing the treatment method for patients with fractures of the head of the radius of various types was proposed and tested in clinical practice. The result of treatment of 104 patients with an average age of 43.5±14.1 years with 106 different fractures of the head of the radius was evaluated. Of these, 65 patients with 67 fractures (group 1) were treated according to the algorithm proposed by the authors, and 39 patients with 39 fractures (group 2) were treated contrary to this algorithm.

RESULTS. The results of treatment for more than 6 months in both groups were evaluated on the Mayo Elbow Performance Score (MEPS). In the group 1, excellent results were obtained in 51 (76.1 %), good – in 13 (19.4 %), satisfactory – in 2 (3.0 %), bad – in 1 (1.5 %) cases. In the group 2, excellent results were obtained in 9 (23.1 %), good – in 14 (35.9 %), satisfactory – in 9 (23.1 %), bad – in 7 (17.9 %) cases. Thus, in the group 1, the treatment results were significantly better than in the group 2 (at p<0.0001). With the analysis of the long-term results of treatment depending on the type of fracture, it was found that significantly (at p<0.05) the best results of surgical treatment for all types of fractures were also obtained in patients of group 1.

CONCLUSION. The obtained results of the clinical trial confirm the effectiveness of the proposed algorithm for choosing method for the treatment of patients with fractures of the head of the radius.

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