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Radial head fractures: effectiveness of conservative treatment versus surgical intervention. A systematic review
P A A Struijs1, G Smit, E Ph Steller
1Department of General Surgery and traumatology, St. Lucas Andreas Hospital, Frederik Hendrikplantsoen 74-2, 1052 XW Amsterdam, The Netherlands. paastruijs@hotmail.com
Introduction:
Radial head fractures are common elbow fractures. The Mason classification is used to describe the fracture. As of yet, there is no consensus on optimal treatment strategy for Mason II-IV fractures. The aim of this study was to compare the results of conservative treatment with different surgical strategies for radial head fractures.
Materials And Methods:
Electronic databases from 1966 to 2004 were screened. Based on our inclusion criteria, 24 studies, describing 825 patients, were included.
Results:
For Mason type II fractures, residual pain was present in 42% of the conservatively treated of the patients compared to 32% of the surgically treated patients. Good/excellent results for Broberg score were 52 and 88%, respectively. For Mason type III and IV fractures, no conservatively treated patients were described.
Conclusions:
There is insufficient evidence to be able to draw definitive conclusions on optimal treatment of type II-IV radial head fractures. Evidence is currently limited to a maximum level II evidence. There is great need for sufficiently powered randomized controlled trials.
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