Arthroscopic debridement of the elbow for arthrofibrosis resulting from nondisplaced fracture of the radial head.

摘要

PURPOSE: Mason type I fractures of the radial head consist of fractures that occur without displacement. Arthrofibrosis is a rarely reported complication of Mason I radial head fractures. Symptoms include pain, stiffness, and crepitus. We assessed the efficacy of an arthroscopic procedure including debridement and capsular release for patients with persistent symptoms and failure of nonoperative therapy. TYPE OF STUDY: Therapeutic study, case series. METHODS: Retrospective analysis of functional outcome data was carried out for all eligible cases treated at our institution between 1995 and 2003. Twenty procedures were performed, with 8 patients lost to follow-up. The outcome data consisted of range of motion measurements and functional indices derived from the Mayo Performance Index (MPI). Mean follow-up duration was 54 months. RESULTS: Surgical findings included extensive scarring in the radiocapitellar joint, cartilage loss in the radial head and capitellum, scarring and synovitis in the ulnohumeral joint, and scarring with adhesions in the posterior compartment and posterolateral gutter. The mean MPI score preoperatively was 64.1 and the mean postoperative score was 89.5. Total range of motion arc rose from 108 degrees preoperatively to 126 degrees postoperatively. CONCLUSIONS: The outcome data suggest that arthroscopic debridement and capsular release is an effective method of treating arthrofibrosis resulting from Mason I radial head fractures. LEVEL OF EVIDENCE: Level IV.