Comparison of Radial Head Prosthesis versus Excision in Comminuted Radial Head Fractures: A Retrospective Comparative Study.

INTRODUCTION

Complex comminuted fractures of the radial head (Mason type III/IV) remain challenging to manage. This study compares functional and clinical outcomes between radial head prosthesis and excision.

MATERIALS AND

METHODS

This retrospective study included 40 adult patients who underwent operative management for acute, displaced radial head fractures (Mason Type III or IV) at a single institution between November 2022 and November 2024. A total of 2 years of the patient's medical records, operative reports, and radiographic images were reviewed. Patients were categorized into two treatment groups: Group A (Excision, n = 20) receiving radial head excision and Group B (Replacement, n = 20) treated with metallic radial head replacement arthroplasty. Inclusion criteria required a minimum of 6-month follow-up. Pre-operative data, including patient demographics, injury mechanism, and fracture classification, were collected, and post-operative follow-up data focused on assessing clinical outcomes using the Mayo Elbow performance index (MEPI) and Broberg-Morrey scores, alongside complications.

RESULTS

Mean age was 44 years of age with a standard deviation of ±7.4. Operative time (69.85 vs. 50.4 min, P < 0.001) and hospital stay (7.6 vs. 4.95 days, P = 0.0003) were longer for the prosthesis. MEPI and Broberg-Morrey scores were higher in the prosthesis group at all follow-ups (P < 0.05). Instability occurred in 40% of excision cases but none in prosthesis cases.

CONCLUSION

Radial head replacement offers better early functional outcomes and joint stability.