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Radial head fractures: effectiveness of conservative treatment versus surgical intervention

A systematic review

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Radial head fractures are common elbow fractures. The Mason classification is used to describe the fracture. As of yet, there is no consensus on optimal treatment strategy for Mason II–IV fractures. The aim of this study was to compare the results of conservative treatment with different surgical strategies for radial head fractures.

Materials and methods

Electronic databases from 1966 to 2004 were screened. Based on our inclusion criteria, 24 studies, describing 825 patients, were included.

Results

For Mason type II fractures, residual pain was present in 42% of the conservatively treated of the patients compared to 32% of the surgically treated patients. Good/excellent results for Broberg score were 52 and 88%, respectively. For Mason type III and IV fractures, no conservatively treated patients were described.

Conclusions

There is insufficient evidence to be able to draw definitive conclusions on optimal treatment of type II–IV radial head fractures. Evidence is currently limited to a maximum level II evidence. There is great need for sufficiently powered randomized controlled trials.

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References

  1. Bakalim G (1970) Fractures of the radial head and their treatment. Acta Orthop Scand 41:320–331

    Article  PubMed  CAS  Google Scholar 

  2. Broberg MA, Morrey BF (1987) Results of treatment of fracture dislocations of the elbow. Clin Orthop Rel Res 216:109–119

    Google Scholar 

  3. Broberg MA, Morrey BF (1986) Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 68(5):669–674

    PubMed  CAS  Google Scholar 

  4. Coleman DA, Blair WF, Shurr D (1987) Resection of the radial head for fracture of the radial head. Long term follow-up of seventeen cases. J Bone Joint Surg Am 69A:385–392

    Google Scholar 

  5. Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma 9(4):318–323

    Article  PubMed  CAS  Google Scholar 

  6. Frankle MA, Koval KJ, Sanders RW, Zuckerman JD (1999) Radial head fractures associated with elbow dislocations treated by immediate stabilization and early motion. J Shoulder Elbow Surg 8(4):355–360

    Article  PubMed  CAS  Google Scholar 

  7. Geel CW, Palmer AK, Rüedi T, Leutenegger AF (1990) Internal fixation of proximal radial head fractures. J Orthop Trauma 4:270–274

    Article  PubMed  CAS  Google Scholar 

  8. Goldberg I, Peylan J, Yosipevitch Z, Tiqva P (1986) Late results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am68A:675–679

    Google Scholar 

  9. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V (2001) The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma 50(1):46–52

    Article  PubMed  CAS  Google Scholar 

  10. Heim U (1992) Surgical treatment of radial head fractures. Z Unfallchir Versicherungsmed(German) 85:3–11

    CAS  Google Scholar 

  11. Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK (2004) Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg 86:1925–1930

    PubMed  Google Scholar 

  12. Holmenschlager F, Halm JP, Piatek S, Schubert S, Winckler S (2002) Comminuted radial head fractures. Evaluation of the bipolar radial head prosthesis of Judet. Unfallchirurg 105:344–352

    Article  PubMed  CAS  Google Scholar 

  13. Ikeda M, Oka Y (2000) Function after early radial head resection for fracture. A retrospective study of 15 patients followed for 3–18 years. Acta Orthop Scand 71(2):191–194

    Article  PubMed  CAS  Google Scholar 

  14. Janssen RPA, Vegter J (1998) Resection of the radial head after Mason type III fractures of the elbow. Follow up at 16 to 30 years. J Bone Joint Surg Br 80B:231–233

    Article  Google Scholar 

  15. Johnston GW (1961) A follow-up of one hundred cases of fracture of the radius with a review of the literature. Ulster Med J 31:51–56

    Google Scholar 

  16. Khalfayan EE, Culp RW, Alexander AH (1992) Mason type II radial head fractures: operative versus nonoperative treatment. J Orthop Trauma 6(3):283–289

    Article  PubMed  CAS  Google Scholar 

  17. King GJ, Evans DC, Kellam FJ (1991) Open reduction and internal fixation of radial head fractures. J Orthop Trauma 5:21–28

    Article  PubMed  CAS  Google Scholar 

  18. Knight DJ, Rynaszewski LA, Amis AA, Miller JH (1993) Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br 75:572–576

    PubMed  CAS  Google Scholar 

  19. Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132

    Article  PubMed  CAS  Google Scholar 

  20. Meier-Marcotty MV, Lahoda LU, Hahn MP, Muhr G (2002) Differential therapy for radial head fractures: critical analysis of the results from 53 patients. Unfallchirurg 105:532–539

    Article  Google Scholar 

  21. Miller GK, Drennan DB, Maylahn DJ (1981) Treatment of displaced segmental radial head fractures. J Bone Joint Surg Am 63A:712–717

    Google Scholar 

  22. Moore T (1981) Fractures of the radial head. A long-term follow-up. J R Coll Surg Edinb 26(5):289–291

    PubMed  CAS  Google Scholar 

  23. Pelto K, Hirvensalo E, Böstman O, Rokkanen P (1994) Treatment of radial head fractures with absorbable polyglycolide pins: a study on the security of the fixation in 38 cases. J Orthop Trauma 8(2):94–98

    Article  PubMed  CAS  Google Scholar 

  24. Popovic N, Rodriguez PhG, Lemaire R (2000) Fracture of the radial head with associated elbow dislocation: results of treatment using a floating prosthesis. J Orthop Trauma 14(3):171–177

    Article  PubMed  CAS  Google Scholar 

  25. Radin EL, Riseborough EJ (1966) Fractures of the radial head. A review of eighty-eight cases and analysis of the indications for excision of the radial head and non-operative treatment. J Bone Joint Surg Am 48A:1055–1064

    Google Scholar 

  26. Sanchez-Sotelo J, Romanillos O, Garay EG (2000) Results of acute excision of the radial head in elbow radial head fracture-dislocations. J Orthop Trauma 14(3):354–358

    Article  PubMed  CAS  Google Scholar 

  27. Stoffelen DV, Holdsworth BJ (1994) Excision or Silastic replacement for comminuted radial head fractures. A long-term follow-up. Acta Orthop Belg 60(4):402–407

    PubMed  CAS  Google Scholar 

  28. Swanson AB, Jaeger SH, La Rochelle D 1981 Comminuted fractures of the radial head. The role of silicone implant replacement arthroplasty. J Bone Joint Surg Am 63A(7):1039–1049

    Google Scholar 

  29. Teasdall R, Savoie FH, Hughes JL (1993) Comminuted fractures of the proximal radius and ulna. Clin Orthop Rel Res 292:37–47

    Google Scholar 

  30. Vierhout RJ, Oostvogel HJM, Van Vroonhoven ThJMV (1983) Internal fixation of fractures of the head of the radius. Neth J Surg 35(1):13–16

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery and traumatology, St. Lucas Andreas Hospital, Frederik Hendrikplantsoen 74-2, 1052 XW, Amsterdam, The Netherlands

    P. A. A. Struijs

  2. Department of General Surgery and traumatology, St. Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    G. Smit & E. Ph. Steller

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  1. P. A. A. Struijs
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  2. G. Smit
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  3. E. Ph. Steller
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Correspondence to P. A. A. Struijs.

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Struijs, P.A.A., Smit, G. & Steller, E.P. Radial head fractures: effectiveness of conservative treatment versus surgical intervention. Arch Orthop Trauma Surg 127, 125–130 (2007). https://doi.org/10.1007/s00402-006-0240-4

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  • DOI: https://doi.org/10.1007/s00402-006-0240-4

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