Open reduction and internal fixation vs. radial head resection in treatment of Mason III or IV radial head fractures

Objective To analyze the clinical results of open reduction and internal fixation (ORIF)vs. radial head resection (RHR) in treatment of patients with a Mason Ⅲ or Ⅳ radial head fracture.Methods We enrolled 30 patients with a Mason Ⅲ or Ⅳ radial head fracture who had been treated in our department from January 2002 to December 2008. In this study, 19 cases received ORIF and 11 cases underwent RHR. The fracture of ulna coronoid process and the medial collateral ligaments were treated at the same time. The 2 groups were compared in muscle weakness, wrist pain, joint range of motion, carrying angel and Broberg-Morrey functional rating score. Results The ORIF group was followed up for 1.0 to 5.5 years, with an average of 30 months. The RHR group was followed up for 2 to 6 years, with an average of 33 months. The postoperative wrist pain and the carrying angle were significantly increased in the RHR group( P ＜ 0.05) . Broberg-Morrey score system showed a good to excellent rate of 74% (14/19) in the ORIF group and a good to excellent rate of 64%(6/11 ) in the RHR group, with no significant difference between the 2 groups ( P = 0. 429). Conclusion In treatment of a Mason Ⅲ or Ⅳ radial head fracture, ORIF may be preferred because the radial head is preserved as far as possible so that the patient may have better prognosis. Key words: Radius; Fractures; Fracture fixation, internal