Anterior capsule re-attachment in terrible triad elbow injury with coronoid tip fracture.

Autor: Antoni M; Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: dr.maxime.antoni@gmail.com., Eichler D; Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France., Kempf JF; Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France., Clavert P; Service de chirurgie du membre supérieur, hôpital de Hautepierre 2, CHU Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2019 Dec; Vol. 105 (8), pp. 1575-1583. Date of Electronic Publication: 2019 Nov 12.
DOI: 10.1016/j.otsr.2019.09.024
Abstrakt: Background: During the surgical treatment of terrible triad elbow injury (TTEI), the usefulness of re-attaching the anterior joint capsule when the coronoid tip is fractured remains unclear. The primary objective of this study was to assess potential benefits during surgery for TTEI of re-attaching the joint capsule when the coronoid tip is fractured.
Hypothesis: Re-attaching the anterior joint capsule in TTEI with a fractured coronoid tip improves clinical and radiological outcomes and decreases the complication and revision rates.
Materials and Methods: This single-centre retrospective study included patients who underwent surgery at the acute phase of TTEI with a fractured coronoid tip. In all patients, a physical examination and elbow radiographs were performed at least 1year after surgery. A statistical analysis was done to compare the groups with vs. without re-attachment of the anterior capsule and coronoid tip.
Results: The study included 30 patients, 16 females and 14 males, with a mean age of 51years (range: 21-84years). Among them, 11 did and 19 did not undergo re-attachment. The two groups were comparable regarding demographic features and follow-up duration. No significant differences were found at last follow-up for flexion-extension motion arc (p=0.75), pronation-supination motion arc (p=0.3051), or the Mayo Elbow Performance Score (p=0.19). Radiographic evidence of humero-radial osteoarthritis was significantly more common in the absence of re-attachment (p=0.04), whereas no differences were evidenced regarding humero-ulnar osteoarthritis (p=0.73), the occurrence of subluxation or dislocation (p=0.43), or loosening of the radial head implant (p=0.47). The complication and revision rates were similar in the two groups.
Conclusion: In our experience, re-attaching the anterior capsule during the surgical treatment of TTEI with a coronoid tip fracture did not improve the clinical or radiographic outcomes after a mean follow-up of 54months.
Level of Evidence: IV, retrospective study.
(Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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