Artikel
Radial head resection with limited synvectomy for hemophiliac elbow arthrpathy
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Veröffentlicht: | 5. Oktober 2015 |
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Gliederung
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Objectives: Recurrent hemarthrosis and synovitis in hemophilic patients result with arthropathy of the radiocapitellar joint and blockage of the forearm rotation. The aim of this study is to evaluate the the midterm results of radial head excision with partial synovectomy in severe hemophilic patients retrospectively.
Methods: Persistent pain and decreased forearm rotation were the main indications for radial head excision. Between 2002-2013, radial head excision were performed for 14 elbows of 14 patients. 12 patients were hemophilia A whereas 2 patients were hemophilia B patients. The mean age of the patients was 29 at the time of the surgery. The mean follow-up was 51(12-155) months. VAS( visual analog score) for pain, forearm rotation, qDASH, MEPS(Mayo Elbow Performance Score) were used as the primary outcome parameters.
Results and Conclusion: At the latest follow-up, all elbows were stabil. The mean VAS decreased significantly from 6.5 preopartively to 2.2 at the final follow-up (p<0.05). The mean fore arm rotation increased from 40 ° to 115° respectively (p<0.05). In 2 patients, efficacious rotation increase was not achieved due to distal radioulnar joint problems.
The mean qDASH score and MEPS were 18.1 and 87.5 at the latest follow-up respectively where 4 patients had excellent and 10 patients had good results. Radial head excision is a safe and effective procedure for hemophylic patients with radiocapitellar arthropathy and decreased fore arm rotation. Distal radioulnar joint should be evaluated preoperatively which may impair the results.