Evaluation of Radiocapitellar Arthritis in Patients with a Second Radiograph at Least 2 Years after Nonoperative Treatment of an Isolated Radial Head Fracture

BackhroundsTo study if patients that have a second radiograph 2 or more years after nonoperativetreatment of an isolated radial head fracture have radiocapitellar osteoarthritis (RC OA)MethodsWe used the database of 3 academic hospitals in one health system from 1988 to 2013 tofind patients with isolated radial head fractures (no associated ligament injury or fracture)that had a second elbow radiograph after more than 2 years from the initial injury. Of 887patients with isolated radial head fractures, %6( 54) had an accessible second radiographfor reasons of a second injury (%57), pain (%30), or follow-up visit (%13). Two orthopedicsurgeons independently classified the radial head fractures on the initial radiographs usingthe Broberg and Morrey modified Mason classification, and assessed the development ofRC OA on the final radiograph using a binary system (yes/no). Results: Four out of %7.5( 54) patients had RC OA, one with isolated RC arthrosis that seemedrelated to capitellar cartilage injury, and 3 that presented with pain and had global OA (likelyprimary osteoarthritis).ConclusionsWith the caveat that some percentage of patients may have left our health system duringthe study period, about 1 in 887 patients (%0.1) returns with isolated radiocapitellararthritis after an isolated radial head fracture, and this may relate to capitellar injury ratherthan attrition. Patients with isolated radial head fractures can consider post-traumaticradiocapitellar arthritis a negligible risk.