PMC4888862_01
Anteroposterior view of the elbow on admission.. Note: A and B show the displacement of the radial head fracture, respectively.
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The initial radiographs revealed complete fracture-dislocation of the head and neck of the radius, with a large fragment of the radial head lateral to the shaft of the radius and posterior to the elbow joint (Figure 1).
Unstable complex fractures of the head and neck of the radius treated by a mini T-shaped plate.. Notes: (A) Radial-head comminuted fracture, lateral collateral ligament disruption from the point of insertion to the distal humerus, which was not associated with neural injury; (B, C) radial-head reconstruction and preliminary fixation with 1 mm Kirschner wires; (D) intraoperative radiographs showing right position of mini T-shaped plate; (E, F) fixation of the fracture with mini T-shaped plate.
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After refreshing the fracture site, these fragments were fixed with a mini T-shaped plate and screws (Synthes [Shanghai] Medical Trading Co., Ltd, Guangzhou, People's Republic of China) (Figure 2), and then the damaged periosteum was interruptedly sutured using absorbable sutures.
Postoperative radiographs demonstrating good reduction and fixation of the comminuted fragments.. Notes: (A) Lateral radiograph of the right elbow showing well-reduced articular and normal position of a mini T-shaped plate and (B) anteroposterior radiograph showing normal radiocapitellar joint and the radial-head fragment fixed with a mini T-shaped plate.
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The postoperative radiographs of the elbow showed that the fixation device was stable and nondisplaced (Figure 3).
Bone union at 12 months after anatomic reduction of the intra-articular surface of the radial head and stabilization with a mini T-shaped plate.. Notes: (A) Anteroposterior; (B) lateral radiographs of right elbow; and (C) removing a mini T-shaped plate at 12 months, without early fusion of the epiphysis, radial head overgrowth, or avascular necrosis.
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After the metalwork was removed at 1 year (Figure 4), no comment was made regarding the complications associated with the use of the internal fixator, and the patient was symptom-free with full range of motion in the elbow joint.
Final follow-up 1 year after trauma.. Note: At final follow-up 1 year after trauma, the patient was symptom-free and had full range of motion in the elbow joint, including flexion-extension (A, B) and supination-pronation (C, D) of the forearm.
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The Mayo Elbow Performance Score was 97 (excellent) (Figure 5).