Comparison between radial head resection and open reduction and internal fixation in clinical treatment of Mason type- III comminuted fractures of radial head

Objective To compare the clinical results of radial head resection with those of open reduction and internal fixation in treatment of Mason type- Ⅲ comminuted fracture of radial head. Methods 58 cases of Mason type- Ⅲ radial head fracture were treated in our department from January, 1983 to July, 2005. 28 cases had resection of the fractured redial head, while the other 30 cases had open reduction and internal fixation. The outcomes were assessed on the basis of pain, motion, strength, radiographic findings, and elbow functional rating score. Results The resection group had a mean follow- up of 5.5 years (2 to 6), while the internal fixation group had 10 years (3 to 13). The average pain VAS (visual analog scale) score was 18.7 (11 to 25) for the resection group and 23.5 (17 to 25) for the fixation group with a P value of 0.0023. The elbow extension averaged - 12.4° in the resection group and - 5.8° in the fixation group (P 0.01). The elbow flexion and the forearm rotation range showed no statistical difference between the 2 groups( P 0.05) , but the decrease of elbow extension and forearm rotation differed statistically between the 2 groups (P 0.01). In the resection group the carrying angle averaged 8.7° and shift of radius averaged 2.1 mm while 1.3° and 0.3 mm in the fixation group (P 0.01). The mean Broberg and Morrey functional rating score was 80.3 for the resection group and 91.3 for the fixation group(P 0.01). Conclusion Compared with resection of the fractured radial head, open reduction and internal fixation can result in more satisfactory elbow motion, greater muscle strength and better functional recovery in the treatment of Mason type- Ⅲ comminuted fracture of radial head