The Best Option in Treatment of Modified Mason Type III Radial Head Fractures: Open Reduction and Internal Fixation Versus Radial Head Excision

Background: Radial head fractures commonly occur during elbow traumas. Among those, treatment of Mason type IIIfractures is still under controversy. Common treatment methods for these fractures include open reduction and internalfixation (ORIF) as well as radial head excision. In this study, we compared long-term outcomes of both methods intreatment of patients with Mason type III fractures of radial head.Methods: Fifteen men and five women with Mason type III radial head fractures were evaluated retrospectively. Tenpatients had undergone excision whereas the other ten patients had been treated with ORIF. Outcomes were assessedbased on stability and range of motion of the elbow joint, grip strength, and pain. Data were gathered using Mayo elbowperformance index (MEPI), Oxford elbow score, and disability of arm-shoulder-hand (DASH), along with the short form(SF)-36 questionnaire.Results: The mean age of the subjects was 36.25±9.22 years and the mean follow-up time was 25.05±11.43months. The ranges of extension and supination, and frequency of pain reporting was significantly different betweenthe groups. The average grip strength in the operated side was significantly higher in the ORIF group, comparedwith the excision (P= 0.03). Ten (100%) patients of ORIF group and 5 (50%) patients of excision group had elbowjoint stability (P=0.01). Mean MEPI and DASH scores were significantly higher in ORIF group (Prespectively).Conclusion: The results are in favor of ORIF method. Therefore, this method is recommended and preferredover excision in treating radial heads with Mason type III frac ture.Level of evidence: III

Keywords:

Excision , Mason type III , Open reduction and internal fixation , ORIF , Radial head fractures , Resection