Mason II-III radial head and neck fractures treated with locking plate fixation

Abstract

Introduction :Internal fixation of radial head and neck fractures is difficult and postoperative complications are common. Our aim in this study was to evaluate elbow function and postoperative complications in patients who underwent internal fixation with the diagnosis of mason 2 and 3 radial head and neck fractures and we discuss our findings in light of the recent literature Materials and Methods: We included 27 patients with treatment radial head and neck fractures. Patients were an average age of 35.4 years (23 – 58) and mean follow up time was 31.6 months (13 – 61). 5 patients (18.5%) had a Mason type 2 fracture and 22 patients (81.5%) Mason type 3 fracture. Postoperative assessments included evaluation of range ofmotion, functional scores, and radiologic findings. We assessed fracture healing, surgical complications,revision surgery, and the need for metal removal. Results: The mean extension deficit was 8° (range 0°- 25°), average elbow flexion 138° (range 95°- 160°), pronation 70° (range 30°- 90°) and supination was 64° (range 20°- 90°). The Mayo Elbow Performance Score showed a mean score of 92 (range 60 – 100). The mean Disability of Arm, Shoulder and Hand score was 15.5 (range 2.5 - 55.2). There were 7 (25,9 %) complications. A total of 6 patients underwent a revision surgery (22.2 %). Conclusions: In conclusion, internal fixation could be an advantageous treatment modality for type II – III radial head and neck fractures. On the other hand, achieving a stable elbow joint should take precedence and arthroplasty should be considered in severely comminuted cases where fixation is not possible.