Epidemiology and Treatment of Radial Head Fractures: A Database Analysis of Over 70,000 Inpatient Cases

J Hand Surg Am. 2021 Jan;46(1):27-35. doi: 10.1016/j.jhsa.2020.05.029. Epub 2020 Aug 11.

Abstract

Purpose: We aimed to study the epidemiology of radial head fractures within a single national registry database while analyzing trends in available treatments.

Methods: A retrospective analysis of data from 2007 to 2016 provided by a national inpatient database registry was performed using the International Classification of Diseases code for radial head fractures and associated German Procedure Classification (OPS) codes. All surgical interventions were evaluated according to fracture type, patient sex and age, and distribution differences over the last decade to detect changes in the treatment trends. The number of major revision procedures was identified and the revision burden for each procedure calculated.

Results: Overall, 70,118 radial head fractures were included, with the annual number rising over 20% during this period. Women were significantly older than men (peak incidence, 55-64 years vs 30-39 years) and more frequently injured (women-to-men, 1.3:1). Surgical interventions increased during the study period, with locking plate fixation of comminuted fractures and radial head arthroplasty (RHA) becoming increasingly performed while radial head resections decreased. The revision burden differed significantly between the fixation techniques, with an increased occurrence of RHA revision procedures more recently.

Conclusions: The data show a higher number and incidence of surgical procedures, especially for comminuted radial head fractures over the study period. Open reduction and internal fixation remains the most frequently used option, with the use of new fixation devices (eg, locking plates) increasing. The use of RHA more than doubled over the past 10 years while the number of radial head resections decreased.

Type of study/level of evidence: Prognostic II.

Keywords: Epidemiology; locking-plate; radial head arthroplasty; radial head fracture; screw fixation.

MeSH terms

  • Bone Plates
  • Elbow Joint*
  • Female
  • Fracture Fixation, Internal
  • Fractures, Comminuted*
  • Humans
  • Inpatients
  • Male
  • Radius Fractures* / epidemiology
  • Radius Fractures* / surgery
  • Retrospective Studies
  • Treatment Outcome