Arthroscopic reduction internal fixation for displaced radial head fractures: a systematic review of the outcomes and complications

Abstract

Background

Arthroscopic reduction internal fixation (ARIF) is gaining popularity for displaced radial head fractures. However, it has yet to be widely performed. ARIF offers a complete view of the articular surfaces of the radial head, capitulum, and coronoid and diagnoses and treats other associated injuries. ARIF provides less soft tissue trauma than open reduction internal fixation (ORIF). ARIF requires a long learning curve and high technical skills. This systemic review aims to examine the functional outcomes and complications of ARIF.

Method

A systematic review of the PubMed, Embase, and Scopus databases was performed. The search terms included “radial head fracture" OR "elbow fracture" AND “arthroscopic fixation" OR “arthroscopy” OR “arthroscopic reduction internal fixation”. Studies were limited to those published in English with reported functional outcome measures and complications. Patient demographic characteristics, clinical outcomes including range of motion, outcome performance scores including Mayo Elbow Performance Score and the Broberg and Morrey Rating System and complications were extracted. The Institute of Health Economics checklist was used for quality assessment.

Results

Five studies met the inclusion criteria. The age ranged from 14 to 72 years, with the mean follow-up length ranging from 1 to 12 months postoperatively. The mean Mayo Elbow Performance Score and Broberg and Morrey Rating System scores for the ARIF group were significantly better than those for the ORIF group. The ARIF group reduced Stiffness and heterotopic ossification considerably compared with that in ORIF.

Conclusion

ARIF is a safe and viable option for treating displaced radial head fractures. It provides less soft tissue trauma and causes less stiffness compared to ORIF.