[Treatment of displaced radial head fractures with internal fixation]

To analyse the procedure and effectiveness of internal fixation in treatment of displaced radial head fractures.

Between August 2005 and May 2009, 35 patients with displaced radial head fractures underwent open reduction and internal fixation with Smart Nail and/or AO mini-plates. There were 28 males and 7 females with an average age of 28.4 years (range, 17-48 years). The injury mechanism included traffic accident in 16 patients, falling in 13, and falling from height in 6. According to Mason classification, 21 fractures were rated as type II, 9 as type III, and 5 as type IV. All fractures were closed fractures. Six cases complicated by radial neck fractures, 1 case by olecranon fracture, 3 by posterior dislocations of the elbow, 1 by posterior dislocation of the elbow and coronoid process fracture, and 3 by medial collateral ligament injuries. The time from injury to operation was 3 to 7 days.

Except 1 patient whose incision healed by second intention, healing of incision by first intention was achieved in the other patients. All patients were followed up 12-25 months with an average of 17 months. The average fracture healing time was 10.2 weeks (range, 8-16 weeks). At last follow-up, the average flexion and extension of the elbow was 119 degrees (range, 95-145 degrees). The average arc of forearm rotation was 126 degrees (range, 90-175 degrees). According to elbow functional evaluation criteria by Broberg and Morrey, the results were excellent in 18 cases, good in 13, and fair in 4; the excellent and good rate was 88.6%.

In treatment of displaced radial head fractures, open reduction and internal fixation can be performed with Smart Nail and/or AO mini-plates based on different fracture types and the short-term effectiveness is satisfactory.