Functional and proprioceptional evaluation of different surgical modalities for radial head fractures

The study of the long term proprioceptional and functional differences between different surgical techniques for the radial head fractures, a very common and disabiling type of elbow trauma, a very common and disabling type of elbow fracture, is an important parameter; that has not been studied and evaluated yet, to achieve better outcomes with the surgical treatment and physical rehabilitation of the elbow fractures, to contribute the functional quality of the patient populations in the need of professional level of proprioception, and to contribute the daily living quality of the disabled ones having severe proprioceptional impairments.As the median, mean, minimum and maximum values of the tests performed for the long-term results of different surgical modalities recently been preferred for the radial head fractures are evaluated and ranked in order of the highest to the lowest, the best to the worst; Jamar Hand Grip Strengths were as Prosthesis, OR+IF, Excision; DASH scores were as OR+IF, Prosthesis, Excision; Mayo Elbow Performance Scores were as OR+IF, Prosthesis, Excision; Passive reposition performances were as Excision, OR+IF, Prosthesis; Active reposition performances were as Excision ? Prosthesis, OR+IF; Flexor Peak Torque performances were as OR+IF, Prosthesis, Excision; Extensor Peak Torque performances were as OR+IF, Prosthesis, Excision; Range of Motions were as Prosthesis, OR+IF, Excision in Flexion; Excision, OR+IF, Prosthesis in Extension; OR+IF, Prosthesis, Excision in Pronation; Prosthesis, OR+IF, Excision in Supination. Valgus angle increase in order of the lowest to he highest were OR+ IF ? Prosthesis, Excision. Extensor peak torque and repositional accuracy were noted to be better in the dominant side mainly by the effect of side dominance than by the type of surgical technique. ROM measurements were more limited in the arthroplasty group, and more lax in the excision group as a hyperpronation and hypersupination pattern. The overall functional and proprioceptional outcomes among all tests were greatest in the osteosythesis group in which the radial head was preserved by radial head reconstruction and so that the direct ( vibration, pressure transmission, friction) and indirect ( restoring the secondary valgus stabilisation, the radial fore arm length and valgus angle, the elbow muscle length-tension relationship in a optimum level) contributions of the radial head to elbow propriception were preserved also. To preserve the proprioceptional functions of the elbow, beyond the preservation of primary stabilizers (ie. MKL), the preservation of secondary stabilizers (ie. Radial Head) should be maintained. So that the elbow muscles? length-tension dynamics may be kept at the optimum level, motor and sensory proprioception may be preserved more efficiently. Among the different surgical modalities recently being used in the radial head fractures, the greatest proprioceptional outcomes were achieved and noted in the osteosythesis (Direct + Indirect contribution) group, then were ranked in order of performance as Arthroplasty ( Indirect contribution) and as Excision (No contribution).