Reconstruction of Mason type-III and type-IV radial head fractures with a new fixation device: 23 Patients followed 1-4 years

Abstract

Background: Treatment options in radial head fractures of Mason types III and IV range from open reduction and internal fixation (ORIF) to radial head resection with or without prosthetic replacement. Patients: In a prospective study, the radiographic and clinical outcome was evaluated in 23 patients (age median 51 years) with 23 complex radial head fractures median 2 (1-4) years after ORIF using a new fixation device (FFS; Orthofix). 14 Mason type-III fractures with 2 concomitant olecranon fractures and 1 ulnar nerve lesion, and 11 type-IV fractures with 2 olecranon fractures and 2 fractures of the coronoid process were treated. 2 patients were lost to follow-up. In 7 cases of joint instability, an elbow fixator with motion capacity was applied after ORIF of the radial head. Results: No radial head resection was necessary. No secondary dislocations or nonunion occurred. The Morrey elbow score was excellent in 8 and good in 4 Mason type-III fractures and excellent in 5, good in 3, and fair in 3 Mason type-IV fractures. Interpretation: Reconstruction of comminuted radial head fractures can be performed with this device and radial head resection can be avoided. Copyright© Taylor & Francis 2007. all rights reserved.