Reconstruction of complex radial head fractures using fine-threaded K-wires : clinical outcome and remaining instability.

Radial head replacement or ORIF are established treatment options for Mason type-III and type-IV fractures. The aim of this study was to provide results for reconstruction of these complex fractures using fine-threaded K-wires. We present results after reconstruction of 15 Mason type-III and 8 Mason type-IV fractures. Parameters used to describe the functional outcome were pain level, range of motion, and clinical scores. To estimate the elbow stability we performed ultrasound examinations under valgus/varus stress. All radial heads could be reconstructed. The average resting pain level was 0.9 of 10. The average ROM for extension/flexion was 134°, average forearm rotation was 159°. For the whole patient collective the mean MEPS was 86.5 points and the mean QuickDASH was 16.8 points with no significant difference for both groups. We can recommend ORIF with fine-threaded K-wires for Mason type-III and type-IV fractures of the radial head. Ligamentous injuries can be addressed successfully with external fixation.