Comparative study on the efficacy of conservative treatment and surgical treatment for simple Mason II radial head fracture.

UNLABELLED: This study aimed to analyze the therapeutic effects of conservative fixation with braces vs. open reduction with internal fixation surgery for simple Mason II radial head fractures.

METHODS

Data from 65 patients with Mason type II radial head fractures treated at the Orthopedics Department of Xi'an Honghui Hospital between January 2018 and January 2021 were analyzed retrospectively. The patients' age range was 18-65 years (mean age, 37.7 years). Thirty-six patients underwent surgical treatment, and 29 underwent conservative treatment. Fracture healing time, elbow joint range of motion, forearm rotation block, pain VAS score, and Broberg-Morrey elbow joint function score were recorded and compared.

RESULTS

All 65 patients completed follow-up. The conservative-treatment group was followed for 3-12 months (mean 5.14 ± 2.13 months). Fracture healing time was 10.41 ± 1.31 weeks. Mean elbow flexion was 134.32° ± 8.59°, extension 7.65° ± 8.27°, and Broberg-Morrey score 90.82 ± 15.51. One patient experienced fracture malunion. The surgical-treatment group was followed for 12-36 months (mean 17.94 ± 4.90 months). Fracture healing time was 10.92 ± 2.78 weeks. Mean elbow flexion was 129.27° ± 15.72°, extension 5.26° ± 5.98°, and Broberg-Morrey score 91.44 ± 17.12. There were two cases of postoperative infection and two cases of internal-fixation failure. No significant intergroup differences were found in fracture healing time, elbow range of motion, forearm rotation, Broberg-Morrey score, or complication rate (P > 0.05). Subgroup analysis showed no significant differences related to gender or hand dominance. In the surgical group, screw fixation and mini plate fixation yielded similar outcomes.

CONCLUSION

Both conservative and surgical treatments achieve favorable bone healing and satisfactory elbow function in simple Mason II fractures. Preoperative CT improves fracture evaluation. Treatment should be individualized based on comprehensive assessment.