Year: 2025
Type: article
Study design: Observational Study
Abstract: Background. There is still no consensus in the international community on which surgical treatment method is preferable for Mason type II and III radial head fractures — osteosynthesis, resection or arthroplasty — since each of these methods is associated with a rather high complication rate, re-operations and unsatisfactory functional outcomes. The aim of the study — to evaluate the medium-term outcomes of surgical treatment of type II and III radial head fractures according to the Mason classification, depending on the treatment modality. Methods. The study included 110 patients who underwent surgery for displaced radial head fractures from 2008 to 2023. Upon admission, all patients had elbow X-rays in two projections and a CT scan. The patients were divided into 3 groups based on the type of surgical treatment: osteosynthesis with cannulated screws; osteosynthesis with a plate and cannulated screws; and resection. We evaluated radiological treatment outcomes, data from the Mayo Elbow Performance Score (MEPS), elbow range of motion, and medical history data, including the presence and timing of postoperative complications and any re-interventions performed due to these complications. Results. Clinical results were observed in 99 (90%) patients: 44 (44%) men and 55 (56%) women. The results of surgical treatment in patients with Mason II radial head fractures were significantly better than in those with Mason III fractures, as evidenced by average MEPS scores (93.0±11.3 and 82.7±16.5, respectively), complication rates (4% vs 17%) and re-operation rates (4% vs 12%). Comparative assessment of the surgical treatment methods according to the MEPS showed significantly better results for osteosynthesis with cannulated screws compared to the use of a mini-plate (93.9±8.8 and 81.9±18.8, respectively, p = 0.005), as well as to radial head resection (93.9±8.8 and 86.4±13.1, respectively, p = 0.036). Fourteen complications were identified in 11 (11%) patients. Fracture nonunion after osteosynthesis was observed in 4 cases, secondary displacement of fragments — in 3 cases. Deep infection was diagnosed in 2 patients after 1 and 4 months after osteosynthesis. Heterotopic ossification of the elbow developed in 2 cases. Conclusion. The findings of the study showed significantly better clinical outcomes and a lower complication rate in the medium term when radial head fractures were treated with osteosynthesis using compression screws compared to the use of a plate or resection.
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410501716