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Operative vs. nonoperative treatment in Mason type II fractures: a meta-analysis
Christian Goy1, Bryan Jm van de Wall1,2, Frank Jp Beeres1,2
1Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
JSES Reviews, Reports, and Techniques
|June 15, 2026
Summary
Operative treatment offers no clear benefit over nonoperative management for Mason type II radial head fractures regarding function or complications. Long-term outcomes, including osteoarthritis risk, require further investigation for definitive treatment decisions.
Area of Science:
- Orthopedic surgery
- Traumatology
- Evidence-based medicine
Background:
- Mason type II radial head fractures are common elbow injuries.
- The optimal treatment strategy, operative versus nonoperative, remains debated.
- Evidence comparing functional outcomes and complications is limited.
Purpose of the Study:
- To systematically compare operative and nonoperative treatment for Mason type II radial head fractures.
- To evaluate differences in functional outcomes, complications, and quality of life.
- To provide evidence to guide clinical decision-making.
Main Methods:
- A meta-analysis of randomized controlled trials and observational studies.
- Systematic literature search across PubMed, Embase, and Cochrane Central Register.
- Pooled analysis of functional outcomes (Mayo Elbow Performance Score), range of motion, and complication rates using random-effects models.
Main Results:
- Four studies with 181 patients were included.
- No significant difference in Mayo Elbow Performance Score between operative and nonoperative groups.
- Similar range of motion and no increased risk of complications or reinterventions in the nonoperative group.
Conclusions:
- Current evidence does not support a clear advantage of operative over nonoperative treatment for Mason type II radial head fractures.
- Long-term risks, such as osteoarthritis, warrant consideration in treatment decisions.
- Further high-quality research with long-term follow-up is necessary.
