Comparison between Two Operations in Clinical Treatment of the Fractures of Radial Head

Objective To compare the clinical results of radial head resection with those of radial prothesis replacement and internal fixation in treatment of Mason type-Ⅲ Ⅳcomminutad fracture of radial head.Methods 26 case of Mason type-Ⅲ Ⅳ radial head fracture were treated in our department from January 1997 to May 2006.14 cases had resection of the fractured radial head,while the other 12 cases had radial prothesis replacement.The outcomes were assessed on the basis of pain,motion,strength,radiographic findings,and elbow functional rating score.Results The resection group had a main follow-up of 5.2 years,while the radial prothesis replacement group had 2 years.The average pain VAS(visual analog scale) score was 18.7 for the resection group and 23.5 for the replacement group.The elbow extension averaged-12.4° in the resection group and-5.8°in the replacement group(P0.01).The elbow flexion and the forearm rotation range showed no statistical difference between the 2 groups(P0.05),but the decrease of elbow extension and forearm rotation differed statistically between the 2 groups(P0.01).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 replacement group(P0.01).The mean Broberg and Morrey functional rating score was 80.3 for the resection group and 91.3 for the replacement group(P0.01).Conclusion Compared with resection of the fractured radial head,radial prothesis replacement can result in more satisfactory elbow motion,greater muscle strength and better functional recovery in the treatment of Mason type-Ⅲ Ⅳcomminutad fracture of radial head.