Open reduction and internal fixation versus radial head arthroplasty in the treatment of adult closed comminuted radial head fractures (modified Mason type III and IV)

Background The purpose of our study was to compare the outcome of radial head fractures (modified Mason type III and IV) treated by open reduction and internal fixation (ORIF) versus radial head arthroplasty (RHA). Patients and methods A retrospective review of 36 patients with closed comminuted radial head fractures treated either by ORIF or RHA with an average of 15-months’ follow-up was undertaken. The primary outcome was the QuickDASH, the shortened version of the Dissabilities of the Arm, Shouler and Hand score. Other outcomes included regain of functional range of motion (ROM) of the elbow and duration of surgery. Surgical complications were noted. Results Thirty-six patients with a mean age of 36 years were evaluated. Nineteen patients underwent ORIF and 17 RHA. The two treatment groups were comparable with regards to gender, side of injury, Mason type and mechanism of injury. Patients who underwent RHA were slightly older ( p < 0.001). At follow-up, the QuickDASH score was similar between groups ( p = 0.58). Regain of functional ROM of the elbow ( p = 0.13) and complication rate ( p = 0.57) were similar. Conclusion The treatment of closed comminuted radial head fracture (modified Mason type III and IV) with ORIF and RHA demonstrates similar findings despite less surgical time for performing RHA.