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Radial Head Fractures Mason Type 3: Comparison of Treatment Options-Open Reduction and Internal Fixation,
Cnaana Dorir1, Ruta Jakusonoka2, Mor Ani3
1Orthopaedic Department, Ziv Medical Center, 13100 Zefat, Israel.
Background:
Treatment of Mason type 3 radial head fractures is not uniform and includes three main options: open reduction and internal fixation (ORIF), radial head arthroplasty (RHA), and radial head excision (RHE). Evidence regarding the optimal surgical treatment option in the literature remains controversial. The purpose of this study was to compare mid-term clinical, radiological, and functional outcomes of ORIF, RHA, and RHE in patients who sustained Mason type 3 radial head fractures.
Methods:
This retrospective study included 56 patients (24 males, 32 females) with a mean age of 49 ± 15 years who were admitted to our medical center from May 2010 to May 2022 and underwent surgery for Mason type 3 radial head fractures. Patients' radiological results, Visual Analog Scale (VAS) scores, Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) scores, ulnar variance, carrying angle, and range of motion were analyzed.
Results:
Thirty-one patients were treated with ORIF, thirteen with RHA, and twelve with RHE surgeries. Mean follow-up was 5.59 years. The patients receiving ORIF, RHA, and RHE had median VAS scores of 5, 1 (p < 0.05), and 3.5; Quick DASH scores of 54, 6.8, and 57 (p < 005); ulnar variance of 7, 7, and 6 (p˃0.05); and carrying angles of 22, 19, and 23 (p = 0.05) degrees, respectively. The RHA group demonstrated the highest range of motion (p < 0.05).
Conclusion:
Radial head arthroplasty for Mason type 3 radial head fractures might be considered in the management of comminuted fractures, as it is possible to achieve good functional results and range of motion in the elbow and radioulnar joints.
