The results of open reduction and screw or K-wire fixation for isolated type II radial head fractures.

Abstract

We evaluated the functional and radiographic results of patients treated with open reduction and screw or K-wire fixation for isolated Mason type II radial head fractures. The study included 21 patients (14 men, 7 women; mean age 36 years; range 25 to 58 years) who were treated with open reduction followed by mini screw (n=11) or K-wire (n=10) fixation for isolated type II radial head fractures. Functional results were evaluated using the modified Morrey functional rating index. Radiographically, osteoarthritis or heterotopic ossification were investigated. The mean follow-up was 30.5 months for K-wire fixation, and 32.1 months for screw fixation. Union was achieved in all the patients, within a mean of 6.2 weeks with screw fixation, and 5.8 weeks with K-wire fixation. The range of motion of elbow flexion-extension and pronation-supination were 131.4 degrees and 144.4 degrees with screw fixation, and 127.5 degrees and 146.5 degrees with K-wire fixation, respectively. The mean Morrey index was 94.5 (range 73 to 100) with screw fixation, yielding excellent or good results in 10 patients. One patient whose result was fair had a 2-mm step-off on the joint surface, resulting in osteoarthritis. The mean Morrey index was 92.1 (range 73 to 100) in the K-wire group, with excellent or good results in nine patients, and fair in one patient. All the patients returned to preinjury work in a mean of 11.7 weeks and 12.5 weeks in screw and K-wire groups, respectively. Heterotopic ossification was not observed. The two fixation groups were similar with respect to union time, joint range of motion, Morrey score, and time to return to work (p>0.05). Our results suggest that both methods provide sufficient fixation resulting in similar functional results in isolated type II radial head fractures.