Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization

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Abstract

BACKGROUND

Radial head fractures often oc cur in association with other el bow fractures and soft-tissue injuries. Radial head replace ment is indicated for irreparable radial head fractures associ ated with elbow instability. The purpose of this study was to an alyze the results after treatment of such injuries with a titanium radial head prosthesis, repair of torn collateral ligaments, and early mobilization of the elbow.

MATERIALS

Sixteen patients with sixteen Mason type-III radial head fractures and collateral liga ment injury were treated with use of a titanium radial head prosthesis over a five-year pe riod at the Royal Adelaide Hos pital and Modbury Public Hospital in South Australia. The surgery was performed acutely in ten patients and was delayed an average of thirty-seven days (range, fifteen to seventy-nine days) in six. All patients were followed clinically and radio graphically for a mean of 2.8 years (range, 1.2 to 4.3 years).

RESULTS

Eight patients had an excel-lent result; five, a good result; and three, a fair result, according to the Mayo Elbow Performance Score. The three fair results oc curred in patients with delayed surgery. The mean flexion con tracture was 15° (range, 0° to 42°), with an average loss of 10° (range, 0° to 25°) of full flexion compared with that of the contralateral elbow. Both pr onation and supination de creased an average of 12° (range, 0° to 45°) compared with that of the contralateral forearm.

CONCLUSIONS

The results of treatment of Ma son type-III radial head fractures with a monoblock titanium radial head prosthesis and soft-tissue reconstruction are satisfactory. Early mobilization of the elbow is important for the restoration of elbow range of motion and function.

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