THE IMPORTANCE OF ELBOW ASPIRATION IN TREATING RADIAL HEAD FRACTURES

Abstract

classified these fractures into 4 types; types I and II are treated conservatively with the aim of early
mobilization, but types III and IV are treated surgically with fracture fixation or excision. Elbow aspiration
for hemoarthrosis is not famous as in the knee, although it is advised to relieve pain. The aim of this study is
to evaluate the effect of elbow aspiration on inra- articular pressure and pain relief in treatment of radial head
fractures. Patients and methods: eighteen patients with radial head fractures were included in this study;
they were 12 males and 6 females, their ages averaged 35years (range 21 - 49 years), right elbow was
affected in 10 cases and left in 8 cases. According to Mason classification 13 cases were type I and 5 cases
type II. All cases were treated by elbow aspiration and posterior slab for 10 to 14 days. Pain was evaluated
using the 10- point Visual Analogue Score (VAS) before and after aspiration. Elbow flexion- extension and
forearm supination- pronation were measured before and after aspiration. Intra-articular pressure was
measured using White-sides method before and after aspiration. Follow up averaged 8 months (range 6-
12 months). Results: pain according to visual analogue score (VAS) improved from average 7 (5- 9) before
aspiration to average 2 (1- 3). Elbow flexion- extension improved from average 62° (range 50°- 75°) before
aspiration to average 110° (range 100°- 125°) after aspiration. Forearm supination- pronation improved from
average 44° (range 35°- 75°) before aspiration to average 100° (range 90°- 110°) after aspiration. Intraarticular
pressure decreased from average 75 mmHg (average 62- 115) before aspiration to average 16
mmHg (range 12- 28) after aspiration. The aspirated amount averaged 9 ml (range 7- 15). At latest follow up
15 cases regained full range of motion (83, 3 %) and all cases showed radiological union. No infection
occurred in this study, no cases of posterior interosseous nerve palsy occurred before or after aspiration.
Conclusion: We recommend elbow aspiration in treating radial head fractures types I and II as a routine
technique; to decrease intra- articular pressure, relieve pain, and allow early mobilization. Elbow aspiration
is a simple, safe technique, no need for special skills or equipment and give dramatic pain relief.
Key words :( Radial head fractures. Elbow aspiration).