A comparative study of functional outcome of type 2 and 3 radial head fracture treated with radial head excision versus radial head fixation

Abstract

Background: This study was conducted to compare the results of radial head excision versus radial head open reduction and fixation in Type 2 and Type 3 Mason fracture of radial head using Quick Dash scoring system. This study suggested better Quick Dash score was associated with radial head fixation as compared to radial head excision.Methods: Out of 40 participants who underwent surgery for Type 2 and 3 Mason radial head head fracture, 20 patients had undergone radial head excision and 20 patients had undergone open reduction and internal fixation. Patients were followed up post-operatively upto 6 months and were evaluated on the basis of Quick Dash scoring system.Results: Out of 40 patients, 27 were males and 13 were females. The Mean age group of this study population was 38.8 years with SD of 12.5 years. Even though, the elbow range of motion was comparable between two groups, those who had undergone radial head excision had an average score of 52.5% where bas those who had undergone radial had fixation had an average score of 60%.additionally patients those who had undergone radial head excision had complaints of elbow instability.Conclusion: Mason Type 2 stable, displaced fractures can be treated satisfactorily with radial head excision, but in the presence of ligamentous injury, there are likely chances of elbow instability and patient may require long term use of orthosis whereas unstable, displaced type 2 Mason fracture and Type 3 communited fracture are better treated with open reduction and internal fixation with either k-wires, screws or plates with fewer complications.