Long-term outcome of displaced radial neck fractures in adulthood: 16-21 year follow-up of 5 patients treated with radial head excision.

BACKGROUND

There have been no reports on the long-term outcome of radial neck Mason type IIIb fractures in adults.

METHODS

3 women and 2 men, aged 46 (22-69) years when they sustained a radial neck Mason type IIIb fracture, were evaluated after an average of 18 (16-21) years. All had been treated with radial head excision.

RESULTS

3 individuals had no subjective elbow complaints while 2 reported occasional weakness. None had severe elbow complaints. The maximum elbow-to-elbow difference in range of motion was a deficit of mean 10 degrees in extension in the injured elbow. Mean deficits in elbow flexion, forearm pronation, and forearm supination were below 5 degrees and the mean difference in cubitus valgus angle was only 2 degrees. There was no instability and no recurrent elbow dislocations. Radiographically, there were cysts, sclerosis, and osteophytes in all formerly injured elbows but none in the uninjured elbows. We found reduced joint space in 1 elbow that had been formerly injured.

INTERPRETATION: Mason type IIIb fracture in adults, treated with radial head excision, appears to have a favorable long-term outcome.