Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis
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Open reduction and internal fixation (ORIF) and radial head arthroplasty (RHA) are the most common operative treatments in patients with radial head fractures. The purpose of this study was to determine the efficacy of RHA and ORIF treatments in patients with radial head fractures (modified Mason type III and IV).
We conducted a computerized search of five electronic databases from their inception to July 2015. All clinical trials comparing ORIF versus RHA treatment in patients with radial head fractures were included. We evaluated the primary outcomes included elbow functional evaluation criteria by Broberg and Morrey, elbow score (Broberg and Morrey), Mayo Elbow Performance Score (MEPS) and QuickDASH score. Secondary outcomes included Visual Analog Scale (VAS), range of motion, operation time and complications. The “assessing risk of bias” table was applied to assess the risk of bias of the included studies.
Eight studies were included in this meta-analysis, which consisted of 138 cases of ORIF and 181 RHA. Methodological quality of the studies was moderate to low. RHA afforded significantly higher satisfaction rate, better elbow score (Broberg and Morrey) and MEPS, shorter operation time, lower incidence of bone nonunion or absorption and internal fixation failure when compared to ORIF. There were no significantly differences in QuickDASH score and other complications.
RHA has better outcome in patients with radial head fractures (modified Mason type III and IV) than ORIF with medium-short-term follow-up period, but longer-term studies will be required to ascertain whether the apparent benefits of RHA were offset by late complications.
Level of evidence
Therapeutic decision analysis; a meta-analysis, Level III.
KeywordsRadial head fracture Terrible triad injuries Radial head fixation Radial head arthroplasty Meta-analysis
We thank the fourth affiliated hospital of Jinan University for assistance in obtaining the texts, which formed the basis of this meta-analysis.
Compliance with ethical standards
There was no fund support in our study. The authors declare that they have no competing interests. This article does not contain any studies with human participants performed by any of the authors.
Conflict of interest
- 4.Bruinsma W, Kodde I, de Muinck Keizer RJ, Kloen P, Lindenhovius AL, Vroemen JP (2014) A randomized controlled trial of nonoperative treatment versus open reduction and internal fixation for stable, displaced, partial articular fractures of the radial head: the RAMBO trial. BMC Musculoskelet Disord 6(15):140–147. doi: 10.1186/1471-2474-15-147 Google Scholar
- 13.Chen X, Wang SC, Cao LH, Yang GQ, Li M, Su JC (2011) Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop 35(2):1071–1076. doi: 10.1007/s00264-010-1107-4 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Liu R, Liu P, Shu H, Gong J, Sun Q, Wu J (2015) Comparison of primary radial head replacement and ORIF (open reduction and internal fixation) in Mason type III fractures: a retrospective evaluation in 72 elderly patients. Med Sci Monit 21(5):90–93. doi: 10.12659/msm.893048 PubMedPubMedCentralGoogle Scholar