The Best Option in Treatment of Modified Mason Type III Radial Head Fractures: Open Reduction and Internal Fixation Versus Radial Head Excision

Abstract

Background: Radial head fractures commonly occur during elbow traumas. Among those, treatment of Mason type III<br />fractures is still under controversy. Common treatment methods for these fractures include open reduction and internal<br />fixation (ORIF) as well as radial head excision. In this study, we compared long-term outcomes of both methods in<br />treatment of patients with Mason type III fractures of radial head.<br />Methods: Fifteen men and five women with Mason type III radial head fractures were evaluated retrospectively. Ten<br />patients had undergone excision whereas the other ten patients had been treated with ORIF. Outcomes were assessed<br />based on stability and range of motion of the elbow joint, grip strength, and pain. Data were gathered using Mayo elbow<br />performance index (MEPI), Oxford elbow score, and disability of arm-shoulder-hand (DASH), along with the short form<br />(SF)-36 questionnaire.<br />Results: The mean age of the subjects was 36.25±9.22 years and the mean follow-up time was 25.05±11.43<br />months. The ranges of extension and supination, and frequency of pain reporting was significantly different between<br />the groups. The average grip strength in the operated side was significantly higher in the ORIF group, compared<br />with the excision (P= 0.03). Ten (100%) patients of ORIF group and 5 (50%) patients of excision group had elbow<br />joint stability (P=0.01). Mean MEPI and DASH scores were significantly higher in ORIF group (Prespectively).<br />Conclusion: The results are in favor of ORIF method. Therefore, this method is recommended and preferred<br />over excision in treating radial heads with Mason type III frac ture.<br />Level of evidence: III