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Reconstruction of Multifragmetary Radial Head Fracture (Mason 3) with Associated Instability

Radius fractures (Mason 3): Osteosynthesis and ligament repair to restore elbow function.

Dr. Savio Chami
Médico Ortopedista
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Descrição

Enhance your skills in the reconstruction of multifragmentary radial head fractures, type Mason 3, associated with joint capsule compromise and coronoid process fracture. This training focuses on the surgical approach aimed at stabilizing the fracture through osteosynthesis, comprehensive ligament repair, and early postoperative management to restore elbow function.

Training Focus:

  • Reconstruction of multifragmentary radial head fractures (Mason 3) with associated instability.
  • Osteosynthesis of the radial head with mini-fragments.
  • Comprehensive repair of ligamentous structures and the coronoid process.
  • Restoration of stability and joint function of the elbow.
  • Early postoperative management and progression of mobility.

Detailed Content:

  • Initial Assessment and Planning: Interpret radiographs to identify complex fractures (Mason 3) and joint impairments. Always plan for ligament repair and have a prosthesis available as an alternative.
  • Surgical Access (Kaplan): Use the Kaplan interval with an incision planned from the lateral epicondyle, ensuring adequate exposure.
  • Exploration and Ligament Preparation: Fracture hematoma indicates joint invasion.Prepare the annular ligament before the opening to facilitate closure. Good visualization of the anterior capsule.
  • Evaluation of the Fracture: Decide between osteosynthesis or arthroplasty based on the periosteum's response to traction of the fragments.
  • Osteosynthesis of the Radial Head: Use 1.5mm screws, parallel or divergent, without crossing, for stable subchondral fixation.
  • Repair of the Coronoid Process and Capsule: Use a 5.0mm metal anchor and high-strength wires for firm suturing of the anterior joint capsule.
  • Lateral Ligament Repair: Reinsert the ligament with anchor and adjust with valgus to ensure adequate tension.
  • Closure and Testing: Close in layers and check the intraoperative range of motion, ensuring no blockages.
  • Post-operative: Initiate early mobility, except for extension (limited to 45° for three weeks). Stability depends on anatomical reduction, not just fixation.

Included Material:

  • Detailed Technical PDF of the Procedure: A comprehensive educational document that details each step of the multifragmentary fracture reconstruction of the radial head (Mason 3) with associated instability.This includes everything from the initial assessment and planning, surgical access, joint exploration, osteosynthesis, repair of the coronoid process and joint capsule, closure of the annular ligament and lateral ligament repair, to closure in layers and intraoperative testing.

Enhance your skills in elbow surgery. Enroll now and master advanced techniques for complex radial head reconstructions, ensuring superior functional outcomes and early rehabilitation for your patients.