[Differential therapy in radial head fractures].

Area of Science:

• Orthopedic Surgery
• Traumatology
• Upper Extremity Reconstruction

Background:

• Radial head fractures, particularly displaced and comminuted types, present a controversial therapeutic challenge.
• Radial head resection has undergone critical review, necessitating an evaluation of its efficacy.

Purpose of the Study:

• To evaluate the functional and radiological outcomes of different treatment modalities for radial head fractures.
• To assess the effectiveness of conservative treatment, open reduction with internal fixation, and radial head resection.

Main Methods:

• Retrospective analysis of 105 radial head fractures treated between 1984-1993 and 1996-1999, with 74 undergoing follow-up.
• Fracture classification using the Mason system; treatment based on fracture type (conservative, ORIF, resection).
• Functional assessment via Broberg and Morrey Index; radiological assessment via Albrecht and Ganz Score.

Main Results:

• Conservative treatment and open reduction/internal fixation yielded excellent/good results in over 80% of cases.
• Radial head resection achieved excellent/good results in 54.6%, satisfactory in 24.2%, and unsatisfactory in 21.2%.
• Unsatisfactory outcomes after resection were often associated with concomitant injuries; ~70% excellent/good for isolated fractures.

Conclusions:

• Radial head resection remains a recommendable procedure for specific radial head fractures when indicated correctly.
• Appropriate patient selection and surgical technique are crucial for optimizing outcomes with radial head resection.
• Conservative and surgical fixation methods demonstrate high success rates for less complex radial head fractures.