Abstract
Purpose
Limited information is available regarding the functional outcomes of radial head fractures managed with open reduction and internal fixation (ORIF). The purpose of this study was to determine the functional outcomes of radial head fractures treated with ORIF.
Method
Fifty-two patients, with a mean age of 4412 years, who were treated with radial head ORIF were evaluated at a mean of 4.42.4 years. Thirty were isolated radial head fractures (Group A), 13 (Group B) were associated with a complex fracture-dislocation (terrible triad variants), and 5 (Group C) were associated with a proximal ulnar fracture (Monteggia/trans-olecranon variants). Fourty-four were partial articular fractures and 8 were complete articular fractures. Outcomes were assessed with physical and radiographic examination, and validated self-reported questionnaires.
Results
The average PREE score (Patient Rated Elbow Evaluation) for Groups A, B, and C were 7.613.1, 12.313.4, and 108.5, respectively. The average MEPI (Mayo Elbow Performance Score) for Groups A, B, and C were 8913, 8511, and 918, respectively. For Groups A, B, and C respectively, the prevalence of radiographic radiocapitellar arthritis was 30%, 46%, and 20%. The average flexion/extension arc for Groups A, B, and C were 7 to 132, 6 to 134, and 10 to 132 respectively. Secondary surgery was performed in 17% of cases, most commonly for decreased motion. Three comminuted fractures failed ORIF and required conversion to radial head arthroplasty.
Conclusion
Patients with radial head fractures, including those associated with complex fracture-dislocations, can achieve excellent functional outcomes with low self reported pain and disability when treated with ORIF, despite radiographic evidence of mild post-traumatic arthritis.
