Publication:

Osteosynthesis, arthroplasty or resection of the radial head-which guarantees the best results in Mason III radial head fractures?

Background Fractures of the radial head are common, accounting for approximately one third of elbow fractures and 4% of all fractures. The most accepted classification is modified Mason, with type III being comminuted fractures, normally requiring surgery. There is currently no consensus on the most effective treatment method.

Methods This study aims to compare the radiological and functional results of Mason III fractures, treated at our hospital between 2017 and 2022. During this period, 23 patients were surgically treated with osteosynthesis, arthroplasty or resection of the radial head. Inclusion criteria (isolated fractures of the radial head with follow-up of more than 6 months) and exclusion criteria (neurovascular, ligament injuries/ other associated fractures) were considered. Functional assessment was based on Broberg-Morrey elbow score; Mayo elbow performance score (MEPS) and QuickDASH.

Results The differences in functional results between the various treatments were not statistically significant (p>0.05), despite the best results being seen in the arthroplasty group.

Conclusions In our series there was a 47.82% complication rate. Five patients developed heterotopic ossification. Which was significantly higher than expected in the arthroplasty treatment group, with a statistically significant difference; but there was no translation in functional terms, since this group achieved the best functional scores. The group of patients who underwent osteosynthesis were those with the worst functional scores and the most complications (3 cases of post-traumatic arthrosis, 3 nonunions and 1 aseptic necrosis). Our series is small, but the results are similar to previous studies.