Abstract
During decennia the treatment of radial head fractures has been controversial. For Mason type II fractures, more recent studies agree that open reduction and internal fixation is the treatment of choice. It restores biomechanical properties, allows an early mobilisation of motion and results in better functional outcome compared with other treatments. In this study, we present the mid-to-long-term results of an arthroscopic technique for reduction and percutaneous fixation. Fourteen patients were available for follow-up with a final assessment performed at an average of 5 years 6 months (range 1 year to 11 years 3 months). Patients were evaluated for pain, motion and radiological findings. The average elbow score (Broberg and Morrey in J Bone Joint Surg Am 68:669–674, 1986) was 97.6 points (range 86–100), corresponding with 3 good and 11 excellent results. Two of the patients with only good results had associated cartilage lesions of the capitellum. Our results show that arthroscopically assisted reduction and internal fixation of type II radial head fractures is a valid technique with consistently good outcome. Although the technique is technically demanding, it allows more precise articular fracture reduction control, as well as better evaluation of associated lesions.
Similar content being viewed by others
References
Bennett J (1993) Radial head fractures: diagnosis and management. J Shoulder Elbow Surg 2:264–273
Broberg M, Morrey B (1986) Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 68:669–674
Bunker T, Newman J (1985) The Herbert differential pitch bone screw in displaced radial head fractures. Injury 16:621–624
Caputo A, Burton K, Cohen M, King J (2006) Articular cartilage injuries of the capitellum interposed in radial head fractures: a report of ten cases. J Shoulder Elbow Surg 15:716–720
Coleman D, Blair W, Shurr (1987) Resection of the radial head for fracture of the radial head.Long term follow-up of seventeen cases. J Bone Joint Surg Am 69:385–392
Dawson F, Inostroza F (2004) Arthroscopic reduction and percutaneous fixation of a radial neck fracture in a child. Arthroscopy 20:90–93
Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma 9:318–323
Goldberg I, Pelan J, Yosiovitch Z (1986) Late results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 68:675–679
Hardy P, Menguy F, Guillot S (2002) Arthroscopic treatment of capitellum fracture of the humerus. Arthroscopy 18:422–426
Herbertsson P, Josefsson P, Hasserius R, Besjakov J, Nyqvist F, Karlsson (2004) Fractures of the radial head treated with radial head excision. J Bone Joint Surg Am 86:1925–1930
Hotchkiss R (1997) Displaced fractures of the radial head: internal fixation or excision? J Am Acad Orthop Surg 5:1–10
Ikeda M, Oka Y (2000) Function after early head resection for fracture: a retrospective evaluation of 15 patients followed 3–18 years. Acta Orthop Scand 71:191–194
Ikeda M, Sugyama K, Kang C, Takagaki T, Oka Y (2005) Comminuted fractures of the radial head Comparison of resection and internal fixation. J Bone Joint Surg Am 87:76–84
Khalfayan E, Culp R, Alexander A (1992) Mason type II radial head fractures: operative versus nonoperative treatment. J Orthopaedic Trauma 6:283–289
Mason M (1954) Some observations on fractures of he head of the radius with a review of one hundred cases. Br J Surg 42:123–132
McArthur R (1987) Herbert screw fixation of fracture of the head of the radius. Clin Orth 224:79–87
Menth-Chiari W, Poehling G, Ruch D (1999) Arthroscopic resection of the radial head. Arthroscopy 15:226–230
Mikic Z, Vukadinovic S (1983) Late results in fractures of the radial head treated by excision. Clin Orthop 181:220–228
Morrey B (1995) Current concepts in the treatment of fractures of the radial head, the olecranon, and coronoid. J Bone Joint Surg Am 77:316–327
Morrey B, An K, Stormont T (1988) Force transmission through the radial head. J Bone Joint Surg Am 70:250–256
Morrey B, Chao E, Hui F (1979) Biomechanical study of the elbow following excision of the radial head. J Bone Joint Surg Am 61:63–68
O’Driscoll S, Morrey B (1992) Arthroscopy of the elbow. J Bone Joint Surg Am 74:84–94
Pearce M, Gallannaugh S (1996) Mason type II radial head fractures fixed with Herbert bone screws. J R Soc Med 89:340–344
Ring D, Quintero J, Jupiter J (2002) Open reduction and internal fixation of fractures of the Radial Head. J Bone Joint Surg Am 84:1811–1815
Rolla P, Surace M, Bini A, Pilato G (2006) Arthroscopic treatment of fractures of the radial head. Arthroscopy 22:233e1–233e6
Sanders R, French H (1986) Open reduction and internal fixation of comminuted radial head fractures. Am J Sports Med 14:130–135
Sowa D, Hotchkiss R, Weiland A (1995) Symptomatic proximal translation of the radius following radial head resection. Clin Orthop 317:106–113
Stothers K, Day B, Regan W (1995) Arthroscopy of the elbow: anatomy, portal sites and a description of the lateral portal. Arthroscopy 4:449–457
Van Glabbeek F, van Riet R, Verstreken J (2001) Current concepts in the treatment of radial head fractures in the adult: a clinical and biomechanical approach. Acta Orthop Belg 67:430–441
van Riet R, Morrey B, O’Driscoll S, Van Glabbeek F (2005) Associated injuries complicating radial head fractures. Clin Orthop 441:351–355
Ward WG, Nunley JA (1988) Concomitant fractures of the capitellum and radial head. J Orthop Trauma 2:110–116
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Michels, F., Pouliart, N. & Handelberg, F. Arthroscopic management of Mason type 2 radial head fractures. Knee Surg Sports Traumatol Arthr 15, 1244–1250 (2007). https://doi.org/10.1007/s00167-007-0378-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-007-0378-9