A comparative study of functional outcome for mason type II & III radial head fractures treated with excision and fixation
Anuroop Pradeep, Ranganath N
The treatment of Mason type II and type III fractures of the radial head has been a long source of contention among orthopaedic surgeons. Radial head excision was the simplest choice for surgical treatment of these fractures. With improvised surgical procedures and availability of highly sophisticated implants and instruments, open reduction and internal fixation (ORIF) of these fractures has become more common. However, the associated complications and outcome of elbow function for both radial head excision and ORIF in managing Mason type II and type III fractures remain yet to be systematically evaluated. To overcome this lacuna, we undertook a retrospective study in Karnataka, India for patients from July 2014 to May 2021 with a mean follow-up period of 161.2 weeks (3.1 years). The study comprised of 20 patients with Mason type II and type III acute fractures of the radial head. Their age group ranged from 20 to 66 years. They were grouped into two categories viz., 10 patients who had their radial heads removed (Group I) and 10 patients who had ORIF with Herbert screws/ mini-plates (Group II). Postoperatively, the final follow-up evaluations of patients were carried out after periods ranging from thirty seven to three hundred and fifty two weeks. During final follow-up, range of motion, radiographic and complications data were collected from patients and functional outcome measures of the elbow were estimated. The rating system of Broberg and Morrey was used to evaluate elbow function. It was observed that the functional rating score averaged 84 points in Group I and 96 points in Group II. Hence, we conclude that the patients who received ORIF had better functional outcome than those who received excision. After radial head excision, the complications recorded were proximal radial migration (n=2) and peri-articular ossification (n=2). When compared with radial head excision treatment, ORIF was found to be better management procedure in terms of adequate joint motion, better function and more strength. These findings suggest the use of ORIF as a more efficient therapeutic option for Mason type II and III radial head fractures.
Anuroop Pradeep, Ranganath N. A comparative study of functional outcome for mason type II & III radial head fractures treated with excision and fixation. International Journal of Orthopaedics Research, Volume 3, Issue 4, 2021, Pages 17-22