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Outcomes of Radial Head Fractures Treated With the “Tripod Technique”

      Purpose

      For fractures requiring operative fixation, the “tripod technique” using headless compression screws has recently been described as a less invasive alternative to open reduction and internal fixation with plate and screws. The purpose of this study was to evaluate the clinical and radiographic outcomes of the tripod technique for the treatment of radial head and neck fractures.

      Methods

      We performed a retrospective chart review of all radial head and neck fractures treated with the tripod technique at our institution over a 10-year period. Patients with less than 6 months of follow-up were excluded. Outcomes were evaluated at the latest follow-up using range of motion measurements and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire.

      Results

      We evaluated 13 patients with a mean age of 48 years and average follow-up of 72 months (range, 21–153 months). All the patients achieved union by 12 weeks after surgery. The average postoperative Quick Disabilities of the Arm, Shoulder and Hand score was 5.9 (range, 0–23). The mean flexion was 139°, and the mean extension was −8°. There were no major postoperative complications. Five patients had minor complications. No patients required a reoperation.

      Conclusions

      The tripod technique is a useful alternative to the traditional method of plate and screw fixation for unstable radial head and neck fractures.

      Type of study/level of evidence

      Therapeutic IV.

      Key words

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      References

        • Jackson J.D.
        • Steinmann S.P.
        Radial head fractures.
        Hand Clin. 2007; 23: 185-193
        • Broberg M.A.
        • Morrey B.F.
        Results of treatment of fracture-dislocations of the elbow.
        Clin Orthop. 1987; : 109-119
        • Mason M.L.
        Some observations on fractures of the head of the radius with a review of one hundred cases.
        Br J Surg. 1954; 42: 123-132
        • Kaas L.
        • Struijs P.A.
        • Ring D.
        • van Dijk C.N.
        • Eygendaal D.
        Treatment of Mason type II radial head fractures without associated fractures or elbow dislocation: a systematic review.
        J Hand Surg Am. 2012; 37: 1416-1421
        • Burkhart K.J.
        • Wegmann K.
        • Müller L.P.
        • Gohlke F.E.
        Fractures of the radial head.
        Hand Clin. 2015; 31: 533-546
        • Sun H.
        • Duan J.
        • Li F.
        Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis.
        Eur J Orthop Surg Traumatol. 2016; 26: 283-291
        • Li N.
        • Chen S.
        Open reduction and internal-fixation versus radial head replacement in treatment of Mason type III radial head fractures.
        Eur J Orthop Surg Traumatol. 2014; 24: 851-855
        • Ring D.
        • Quintero J.
        • Jupiter J.B.
        Open reduction and internal fixation of fractures of the radial head.
        J Bone Joint Surg Am. 2002; 84: 1811-1815
        • Esser R.D.
        • Davis S.
        • Taavao T.
        Fractures of the radial head treated by internal fixation: late results in 26 cases.
        J Orthop Trauma. 1995; 9: 318-323
        • Ikeda M.
        • Yamashina Y.
        • Kamimoto M.
        • Oka Y.
        Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates.
        J Bone Joint Surg Br. 2003; 85: 1040-1044
        • Wu P.H.
        • Shen L.
        • Chee Y.H.
        Screw fixation versus arthroplasty versus plate fixation for 3-part radial head fractures.
        J Orthop Surg (Hong Kong). 2016; 24: 57-61
        • Lipman M.D.
        • Gause T.M.
        • Teran V.A.
        • Chhabra A.B.
        • Deal D.N.
        Radial head fracture fixation using tripod technique with headless compression screws.
        J Hand Surg Am. 2018; 43: 575.e1-575.e6
        • Smith A.M.
        • Morrey B.F.
        • Steinmann S.P.
        Low profile fixation of radial head and neck fractures: surgical technique and clinical experience.
        J Orthop Trauma. 2007; 21: 718-724
        • Li S.L.
        • Lu Y.
        • Wang M.Y.
        Is cross-screw fixation superior to plate for radial neck fractures?.
        Bone Jt J. 2015; 97: 830-835
        • Aasheim T.
        • Finsen V.
        The DASH and the QuickDASH instruments. Normative values in the general population in Norway.
        J Hand Surg Eur. 2014; 39: 140-144
        • Gutowski C.J.
        • Darvish K.
        • Ilyas A.M.
        • Jones C.M.
        Comparison of crossed screw versus plate fixation for radial neck fractures.
        Clin Biomech (Bristol Avon). 2015; 30: 966-970
        • Giffin J.R.
        • King G.J.
        • Patterson S.D.
        • Johnson J.A.
        Internal fixation of radial neck fractures: an in vitro biomechanical analysis.
        Clin Biomech (Bristol Avon). 2004; 19: 358-361
        • Ohly N.
        • Reid J.
        Tripod fixation of radial neck fractures.
        J Bone Jt Surg Br. 2011; 93: 187-188
        • Rebgetz P.R.
        • Daniele L.
        • Underhill I.D.
        • Öchsner A.
        • Taylor F.J.
        A biomechanical study of headless compression screws versus a locking plate in radial head fracture fixation.
        J Shoulder Elbow Surg. 2019; 28: e111-e116