The Long-Term Effects of Radial Head Excision for Mason Type 3 Radial Head Fracture.

Background

Radial head fractures with comminution and displacement present challenges in achieving optimal treatment outcomes in the long term. This study aims to evaluate the long-term effects of radial head excision (RHE) in patients with Mason type 3 fractures.

Methods

We conducted a retrospective study of patients with a Mason type 3 radial head fracture who underwent primary RHE between January 2010 and January 2020. The primary outcome was the Mayo elbow performance score (MEPS). Additionally, joint stability and arthritis, and the carrying angle were recorded for each patient.

Results

In total, 61 patients (21; 34% female) with a follow-up range of 3-13 years were examined. The mean (SD) total MEPS was 91.8 (9.2). The results were excellent for 46, good for 12 and fair for 3 patients. A model of total MEPS adjusted for sex, age and follow-up time showed a significant effect of patient age on treatment success (p < 0.001). Thirteen patients (21%) showed elbow instability. Six individuals had increased valgus laxity. The mean carrying angle was 19° (range: 11°-27°) on the injured side and 9° (4°-15°) on the uninjured side, t(120) = 12.608, p < 0.001. Overall, 37 patients had degenerative changes in the operative elbow.

Conclusions

Benefits of RHE persist for a long time with predominantly excellent elbow function and minimal complications. An increase in the carrying angle, joint instability and degenerative changes are to be expected. Patient age at the time of the surgery can affect treatment outcomes. Level of Evidence: Level IV (Therapeutic).