Surgical treatment of radial head isolated Mason III fractures. (August 2019)

• Record Type: Journal Article
• Authors: Strigini, Giacomo; Rendina, Michele; Ghiara, Matteo; Quattrini, Fabrizio; Ghidoni, Laura; Burgio, Valeria; Maniscalco, Pietro; Benazzo, Francesco
• Is Part Of: Injury. Volume 50(2019)Supplement 4
• Page Start: S2
• Page End: S5
• Publication Date: 2019-08
• Subjects: Radial head -- Capitellectomy -- Resection -- Prosthesis -- Mason; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2018.11.056
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: In radial head fractures associated with other injuries there is clear evidence of the superiority of the prosthesis. In isolated radial head fractures we would recommend as a treatment of choice radial head resection in patients over 50 y.o. in absence of high functional request. In isolated radial head fractures in patients younger then 50 y.o., in athletes or manual worker we believe that prosthetic replacement can be the better solution. Abstract: Introduction: In this retrospective study we have analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with bone resection or prosthesis. Patients and methods: This study includes 24 patients affected by fractures mentioned above and treated between July 2009 and November 2015. 15 patients (average age 48 y.o.) have been treated with prosthesis. The remaining 9 (average age 573) have been treated with a capitellectomy instead. From a clinical point of view, we have evaluated the patients according to main performance indicators such as range of motion, pain, instability and Mayo Elbow Performance Score as parameters. Results: We have found similar results in both group, with an average MEPS value of 95 in the prosthesis group and 966 in the radial head resection group. The range of motion was similar too: between 1, 3° and 1203° in the first group and between 4, 4° and 120° in the second one. No significant complication has detected in any patient. Discussion: According to most recent literature, it is not precisely defined how to treat isolated Mason III fractures, contrary to what is defined in more complex pattern, in which prosthesis are now evaluated as the best indication. Due to radial head limited contribution to elbow stability, in absence of other bony or ligamentous lesions both capitellectomy and prosthesis can be good treatment in this kind of fracture. Conclusion: According to our experience and to the most recent literature, we recommend prosthesis in patient younger than 50 y.o., high demanding or manual worker, while in other cases we think that radial head resection can be the treatment of choice.