Open reduction and internal fixation of radial head fractures.

Background: We evaluated the radiologic and functional outcomes of patients with radial head fractures managed with open reduction and internal fixation.
Methods: Between 1998-2003, 15 patients (7 males, 8 females; mean age 34.1; range 18 to 49 years) with radial head fracture were treated with open reduction and internal fixation. Follow-up time was 54.6 months (42-78). Three fractures were Mason type II, 8 were III and 4 were IV. They were evaluated by anteroposterior and lateral radiographs and functionally by Broberg and Morrey criteria.
Results: All the fractures except in 1 patient with Mason type III had united. The mean range of motion of the elbow was 20 degrees to 145 degrees with 71.9 degrees of pronation and 83.2 degrees of supination. According to Broberg and Morrey criteria, the outcome was excellent in 8, good in 4, fair in 1 and bad in 2. Excision and prosthetic replacement were performed in 1 patient because of implant failure.
Conclusion: We suggest open reduction and internal fixation even in comminuted cases because it gives satisfactory elbow function and avoids radial shortening, loss of motion and wrist joint dysfunction as a result of radial head excision. When it fails, excision and prosthetic replacement can be done later.