{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T13:22:25Z","timestamp":1694611345105},"reference-count":30,"publisher":"Universa BV","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>The management of isolated radial neck and head fractures is controversial. Plate fixation and tripod fixation are two commonly employed techniques but risk damage to soft tissues and implant-related complications. Intramedullary fixation is commonly used in pediatric cases and reduces the potential drawbacks of open fixation. This systematic review aimed to analyze outcomes of intramedullary fixation in adults in terms of function, union, and complication rates. A systematic review of the literature was conducted following the PRISMA guidelines using Medline and EMBASE\u2019s online databases. The review was registered on the PROSPERO database. Studies were appraised using the Methodological Index for non-randomized studies (MINORS) tool. Seven studies were deemed eligible for inclusion (n=55). Mean ages of patients ranged from 31.3 to 44.2 years, and mean follow-up ranged from 9 to 86 months. The Mayo Elbow Performance score (MEPs) was reported in five case series (mean scores 81.8 -97.9) and the prevalence of excellent results ranged from 71% and 83%. Although 100% of fractures united, the pooled complication rate was 24% (range 0-50%). The most common complications were elbow stiffness (7%), superficial radial nerve neuropraxia (7%), malunion (5%), and AVN (1.8%). No study reported any patients requiring revision surgery. Intramedullary fixation for radial head and neck fractures appears to provide a reliable alternative treatment option in terms of union, range of motion, and functional outcomes. Further robust trials direct comparing against open fixation techniques are required.<\/jats:p>","DOI":"10.52628\/89.2.9824","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T14:22:22Z","timestamp":1694528542000},"page":"362-368","source":"Crossref","is-referenced-by-count":0,"title":["The use of intramedullary devices for adult radial head and neck fractures. A systematic review"],"prefix":"10.52628","volume":"89","author":[{"given":"Robert","family":"JORDAN","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"REMTULLA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alistair","family":"JONES","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahbaz","family":"MALIK","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"CHAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunaratnam","family":"SHYAMALAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2023,8]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM (2012). The epidemiology of radial head and neck fractures. J Hand Surg Am 37(1):112e9.","DOI":"10.1016\/j.jhsa.2011.09.034"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Conn J, Wade P (1961). Injuries of the elbow: a ten year review.  J Trauma 1:248-68","DOI":"10.1097\/00005373-196105000-00004"},{"key":"ref2","unstructured":"Wilkins KE (1984). Fractures of the neck and head of the radius. In: Rockwood CA, editor. Fractures in children. Philadelphia:  J.B. Lippincott Cp. p. 502e21."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Schmidt-Horlohe K, Siebenlist S, Stockle U, Pichl J, Hoffmann R (2011). Fractures of the radial head and neck. Z Orthop Unfall. 149(6):69-86 (quiz e87-68).","DOI":"10.1055\/s-0031-1280424"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Burkhart KJ, Gruszka D, Frohn S et al (2015). Locking plate osteosynthesis of the radial head fractures: clinical and radiological results. Unfallchirurg. 118(11):949-56.","DOI":"10.1007\/s00113-014-2562-y"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Zwingmann J, Welzel M, Dovi-Akue D, Schmal H, S\u00fcdkamp NP, Strohm PC (2013). Clinical results after different operative treatment methods of radial head and neck fractures: a systematic review and meta-analysis of clinical outcome. Injury 44:1540-50.","DOI":"10.1016\/j.injury.2013.04.003"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Cronlein M, Zyskowski M, Beirer M et al (2017). Using an anatomically preshaped low-profile locking plate system leads to reliable results in comminuted radial head fractures. Arch Orthop Trauma Surg 137(6):789-795.","DOI":"10.1007\/s00402-017-2693-z"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Lipman MD, Gause TM, Teran VA, Chhabra AB, Deal DN (2018). Radial head fracture fixation using tripod technique with headless compression screws. J Hand Surg Am 43(6):575.","DOI":"10.1016\/j.jhsa.2018.03.009"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Wu PH, Dixit A, Tan DMK, Shen L, Chee YH(2017). Prospective study of surgical fixation of radial head fractures using cannulated headless compression screws for simple and complex radial head fractures. J Orthop Surg (Hong Kong) 25(2).","DOI":"10.1177\/2309499017716278"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Rebgetz PR, Daniele L, Underhill ID, Ochsner A, Taylor FJ (2019). A biomechanical study of headless compression screws versus a locking plate in radial head fracture fixation. J Shoulder Elbow Surg 28(4):e111-e116.","DOI":"10.1016\/j.jse.2018.10.008"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Ries C, Muller M, Wegmann K, Pfau DB, Muller LP, Burkhart KJ (2015). Is an extension of the safe zone possible without jeopardizing the proximal radioulnar joint when performing a radial head plate osteosynthesis? J Shoulder Elbow Surg 24(10):1627-34.","DOI":"10.1016\/j.jse.2015.03.010"},{"key":"ref11","unstructured":"Kang HJ, Shin SJ, Kang SS (2012). Nonunion of the radial neck following operative treatment for displaced radial head and neck fractures. Acta Orthop Belg 78(5):597-602."},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Li SL, Lu Y, Wang MY (2015). Is cross-screw fixation superior to plate for radial neck fractures? Bone Joint J 97-B:830-5.","DOI":"10.1302\/0301-620x.97b6.34868"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Young S, Letts M, Jarvis J (2000). A vascular necrosis of the radial head in children. J Pediatr Orthop 20:15-8.","DOI":"10.1097\/01241398-200001000-00004"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Narang AM, Pandey AA, Bhat M (2020). Management of Severely Displaced Radial Neck Fractures in Children: A Systematic Review and Meta-analysis of Outcomes. Indian Journal of Orthopaedics 54(1):60-68","DOI":"10.1007\/s43465-019-00032-2"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Shabtai l, Arkader A (2016). Percutaneous Reduction of Displaced Radial Neck Fractures Achieves Better Results Compared With Fractures Treated by Open Reduction. J Pediatr Orthop 36 Suppl 1:S63-6.","DOI":"10.1097\/bpo.0000000000000763"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Serbest S, G\u00fcrger M, Tosun HB, Karakurt L (2015). Closed reduction and intramedullary pinning in the treatment of adult radial neck fractures: a case report. Pan Afr Med J 20:434.","DOI":"10.11604\/pamj.2015.20.434.6580"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Moher D, Liberati A, Tetzlaff J, et al (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6:e1000097.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Slim K, Nini E, Forestier D, et al (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712-716.","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Singh N, Pandey CR, John R, Singh R, Tamang B, Bhandari S (2018). The effectiveness of a modified Metaizeau technique in fixation of adult radial neck fractures: a prospective study with a modification of the Broberg-Morrey classification. J Shoulder Elbow Surg 27:411-417.","DOI":"10.1016\/j.jse.2017.09.035"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Kaziz H, Benzarti S, Triki MA, Mouelhi T, Naouar N, Ayeche ML (2018). Outcome of intramedullary pinning of isolated radial neck fractures in adulthood. J Shoulder Elbow Surg 27:1650-1655.","DOI":"10.1016\/j.jse.2018.06.008"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Keller HW, Rehm KE, Helling J (1994). Intramedullary reduction and stabilisation of adult radial neck fractures. J Bone Joint Surg Br 76(3):406-408.","DOI":"10.1302\/0301-620x.76b3.8175842"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Bushu H, Singh SR, Singh LJ, Siddharth S (2019). Radial neck fracture fixation by Metaizeau technique in adults. A case series and review of literature. J Orthop Trauma Rehab 26(1):18-22.","DOI":"10.1016\/j.jotr.2018.03.005"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Gao X, yin HL, Zhou GJ (2019). Minimally invasive treatment of mason type II radial head fracture by intramedullary pinning. Orthop Surg 11:879-885.","DOI":"10.1111\/os.12540"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Sandmann GH, Cronlein M, Neumaier M et al (2016). Reduction and stabilisation of radial neck fractures by intramedullary pinning: a technique not only for children. Eur J Med Res 21:15.","DOI":"10.1186\/s40001-016-0210-4"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Serbest S, Gurger M, Tosun HB, Karakurt L (2015). Closed reduction and intramedullary pinning in the treatment of adult radial neck fractures: a case report. Pan African Medical Journal 20:434.","DOI":"10.11604\/pamj.2015.20.434.6580"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Wu H, Shen L, Chee YH (2016). Screw fixation versus arthroplasty versus plate fixation for 3-part radial head fractures, Journal of Orthopaedic Surgery 24(1):57-61","DOI":"10.1177\/230949901602400114"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Cristofaro CD, Carter TH, Wickramasinghe NR, McQueen MM, White TO, Duckworth AD (2019). High Risk of Further Surgery After Radial Head Replacement for Unstable Fractures: Longer-term Outcomes at a Minimum Follow-up of 8 Years. Clin Orthop Relat Res 477(11):2531-2540.","DOI":"10.1097\/corr.0000000000000876"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Pike JM, Grewal R, Athwal GS, Faber KJ, King GJW (2014). Open reduction and internal fixation of radial head fractures: do outcomes differ between simple and complex injuries? Clin Orthop Relat Res 472(7):2120-2127.","DOI":"10.1007\/s11999-014-3519-8"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Watters TS, Garrigues GE, Ring D, Ruch DS (2014). Fixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis? 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