Self-assessment of Elbow Mobility as a Reliable Method in the Postoperative Follow-up Examination of Radial Head Fractures

Sufficient follow-up of fractures is often difficult, due to age-related, health-related or geographical reasons. Self-assessment of the patient's functional outcome could be an alternative to a personal medical examination. There is a lack of validated questionnaires to record these parameters for elbow injuries. The aim of the study was to validate the patient's self-assessment of the range of motion following surgical treatment of complex radial head fractures.50 patients (42% women) with a mean age of 49.7 ± 13.8 years (range 25-82 years) with a surgically treated radial head fracture (Mason III or IV) were examined, 39.6 ± 23.3 months postoperatively. The fracture was treated with radial head reconstruction (60%) or radial head prosthesis (40%). The follow-up examination included the assessment of elbow mobility using a questionnaire (Elbow Motion Assessment Score) and physical examination using a goniometer. In addition, quality of life was assessed using the SF-36 Health Survey. The agreement of the mobility was recorded as a percentage using Spearman's correlation.Exact agreement between examiner and patient was achieved at 54% in flexion, 40% in extension, 86% in pronation and 54% in supination. The median deviations in agreement were 10° in extension and flexion and 20° in pronation and supination. The correlations were r = 0.550 (flexion), r = 0.841 (extension), r = 0.808 (pronation) and r = 0.754 (supination). Patients who agreed with the examiner on the movements achieved a higher score in the SF-36 Health Survey than patients who did not agree with the examiner (50.5 to 54.1 vs. 40.0 to 45.5).The survey of the range of motion by the patient using a questionnaire showed a high level of agreement with the measurement by an objective examiner. Such self-assessment can therefore be seen as a suitable, cost-effective alternative in the follow-up examination of surgically treated radial head fractures.