Early radial head excision for displaced and comminuted radial head fractures: considerations and concerns at long-term follow-up.

OBJECTIVES

The aim of this study is to retrospectively review the outcomes of patients with comminuted radial head fractures surgically treated with early radial head excision.

DESIGN

Retrospective follow-up study.

SETTING

University orthopaedic trauma center.

PATIENTS: Forty-two patients with unilateral, isolated, closed, displaced, or comminuted radial head fracture (Mason type 2-10, Type 3-32).

INTERVENTION: Early radial head excision.

MAIN OUTCOME MEASUREMENTS: Patients were clinically and radiographically evaluated at an average follow-up of 18 years. The uninjured contralateral limb was used as a comparison. Clinical evaluation was rated using the Broberg and Morrey system, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and the visual analog scale (VAS) for pain.

RESULTS

At last follow-up, 36 patients had no complaints, whereas six admitted to occasional pain. The mean Broberg and Morrey score was 91.2 ± 6.3, and the mean Disabilities of the Arm, Shoulder and Hand score was 10.1 ± 8.8.

CONCLUSION

Early radial head excision represents a viable option in case of displaced and comminuted fractures. According to the results of this study, it demonstrated a high rate of good results and patient satisfaction, a quick recovery after surgery, and a low rate of complications with durable results at long-term follow-up.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.