Open Reduction Internal Fixation of Simple Versus Comminuted Radial Head Fractures: Comparison of Clinical Outcomes

Amanda Walsh, Yiyang Zhang, Joshua McGough, Jaehon Kim, Michael Hausman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Current teaching suggests that modified Mason type III and IV fractures of the radial head involving more than 3 fragments should be treated with radial head arthroplasty. The purpose of this study was to compare the outcome of simple (2 or fewer intra-articular pieces) versus comminuted (3 or more intra-articular pieces) radial head fractures treated with open reduction internal fixation (ORIF). Methods: This was a retrospective review of 35 patients with modified Mason type III and IV fractures treated with ORIF. For the purpose of our study, simple fractures were defined as having 2 or fewer intra-articular fragments. Comminuted fractures were defined as having 3 or more intra-articular fragments. The primary outcomes were Broberg and Morrey rating system and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores. Reoperation rates and complications were also noted. Results: Thirty-five patients were evaluated, with a mean follow-up of 39.3 months. Thirteen patients had radial head fractures consisting of 2 or fewer intra-articular fragments. Twenty-two patients had radial head fractures consisting of 3 or more intra-articular fragments. Ages and follow-up times were similar in the 2 groups. Similar QuickDASH and Broberg and Morrey scores were seen when evaluating subgroups of 2, 3, and 4 fragment fractures. One patient from each group underwent revision surgery for symptomatic hardware. Conclusions: In our series, we found similar clinical outcome scores and reoperation rates between simple and comminuted radial head fractures treated with ORIF. Fractures with more than 3 intra-articular fragments can be considered for ORIF. Type of study/level of evidence: Therapeutic IV.

Original languageEnglish
Pages (from-to)1059.e1-1059.e9
JournalJournal of Hand Surgery
Volume48
Issue number10
DOIs
StatePublished - Oct 2023
Externally publishedYes

Keywords

  • Radial head arthroplasty
  • radial head ORIF
  • radial head fracture

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