Treatment of different types of radial head fractures

Abstract

Objective To investigate the treatment options for different types of radial head fractures and report the clinical outcomes. Methods Retrospective analysis was carried out in 57 patients with radial head fractures treated from February 2004 to April 2008.According to Mason classification,there were 12 cases of Mason typo Ⅰ fractures,24 cases of Mason type Ⅱ fractures,19 cases of Mason type Ⅲ fractures and 2 cases of Mason type Ⅳ fractures.Fracture management was based on the type of injury. Results The average followup was 28.4 months (range,18 to 48 months).Functional outcomes were assessed according to Broberg and Morrey score systems.Elbow function was rated excellent in 29 cases,good in 18 cases,fair in 9 cases and poor in 1 case.Excellent and good results were found in 82.5％ of the cases.As to complications,there were 1 case of non-union,4 cases of traumatic ostecarthritis,3 cases of beterotopic ossification,and 1 case of elbow instability.Infection as well as nerve injury was not found in any case.In Mason type Ⅲ Ⅳ fractures significant difference was found in the range of motion between the affected joint and the contralateral one( P ＜0.05). Conclusion Conservative treatment is indicated in the patients with Mason type Ⅰ fractures.Open reduction and internal fixation (ORIF) was required in patients with Mason type Ⅱ fractures combined with elbow instability.ORIF or arthroplasty can be considered in patients with Mason type Ⅲ and Ⅳ fractures.Care should be taken to repair or reconstruct ligament injury to ensure elbow stability.Radial head excision should be considered cautiously. Key words: Elbow joint; Treatment outcome; Radial head fractures