Functional Outcome of Resection versus Reconstruction in Mason II-III Radial Head Fractures; A Short-Term Prospective Study

Abstract

Objective: To compare the short-term functional outcome between resection and reconstruction in Mason Type II and Type III radial head fractures using Broberg and Morrey score.Methods: A prospective cohort study was conducted in the Department of Orthopedic Surgery of SMS Medical College and attached Hospitals. A total of 29 patients (15 in resection group, 14 in reconstruction group) between the age group of 20-60 years with Mason Type II and Type III fresh closed radial head fractures were included in the study. The functional outcome including the range of motion, extension lag and Broberg Morrey score were determined and compared between two group.Results: The mean age of resection group was 44.5 ± 6.6 years and mean age of reconstruction group was 37.1 ± 6.2 years. The baseline characteristics . At 12-months follow-up, in Mason type II fracture, radial head reconstruction group with mean extension lag of 9.4 ± 4.1 and mean Broberg Morrey score of 94.9 ± 5.1 showed better results compared to radial head resection with mean extension lag of 15.7 ± 4.1 (p=0.022) mean Broberg Morrey score 88.3 ± 5.1 (p=0.045) respectively. In Mason type III fractures, radial head resection with mean supination of 79.4 ± 4.7, mean pronation of 74.4 ± 4.1 and mean Broberg Morrey score 89.8 ± 6 showed better results when compared with radial head reconstruction group with mean supination of 64.2 ± 4 (p<0.001), mean pronation of 59.2 ± 8.4 (p=0.003) and mean Broberg Morrey score 81.9 ± 5 (p=0.031).Conclusion: The procedure suggested in Mason type II, is reconstruction of radial head. In Mason type III due to difficulty in achieving anatomical reduction results were not good with reconstruction when compared with resection. We recommend radial head excision in Mason type III fractures where anatomical and stable fixation is not possible.