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

Document Type : RESEARCH PAPER


1 Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

2 Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Radial head fractures commonly occur during elbow traumas. Among those, treatment of Mason type III
fractures is still under controversy. Common treatment methods for these fractures include open reduction and internal
fixation (ORIF) as well as radial head excision. In this study, we compared long-term outcomes of both methods in
treatment 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. Ten
patients had undergone excision whereas the other ten patients had been treated with ORIF. Outcomes were assessed
based on stability and range of motion of the elbow joint, grip strength, and pain. Data were gathered using Mayo elbow
performance 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±11.43
months. The ranges of extension and supination, and frequency of pain reporting was significantly different between
the groups. The average grip strength in the operated side was significantly higher in the ORIF group, compared
with the excision (P= 0.03). Ten (100%) patients of ORIF group and 5 (50%) patients of excision group had elbow
joint 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 preferred
over excision in treating radial heads with Mason type III frac ture.
Level of evidence: III


Main Subjects

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