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Review
. 2023 May;105(5):469-475.
doi: 10.1308/rcsann.2022.0109. Epub 2022 Oct 14.

Current concepts in the management of radial head fractures: a national survey and review of the literature

A Barakat  1 , C Mcdonald  2 , H Singh  2
Affiliations
Review

Current concepts in the management of radial head fractures: a national survey and review of the literature

A Barakat et al. Ann R Coll Surg Engl. 2023 May.

Abstract

Introduction: This study aims to report on current practice in the management of radial head fractures (RHFs) in the United Kingdom and to review the literature to identify areas for future investigation.

Methods: A 12-question online survey was sent to 500 surgeon members of the British Elbow and Shoulder Society in 2021. Questions focused on clinical assessment, indications for surgical treatment and willingness to participate in future studies. Descriptive statistical analysis summarised the responses.

Results: The response rate was 20.4% (n = 102). For minimally displaced RHFs, non-operative management with immediate mobilisation was reported by 90.2% (n = 92) as opposed to 9.8% (n = 10) for initial immobilisation in plaster or brace. The most cited indication for radial head arthroplasty as opposed to fixation was increased patient age or low functional demand in 69.9% of responses (n = 71). In total, 41.2% (n = 42) indicated the need for a future randomised controlled trial (RCT) concerning the management of RHF. Only five RCTs were returned by the literature review.

Discussion: There is considerable variability in the management of RHF among an experienced cohort of surgeons. With the interest declared by the participating surgeons, there is a call for a well-designed sufficiently powered RCT.

Keywords: Elbow fracture; Radial head arthroplasty; Radial head fractures; Randomised controlled trial; Survey.

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Figures

Figure 1
Figure 1
Bar chart demonstrating different surgical indications as per the survey responses
Figure 2
Figure 2
Bar chart demonstrating age implications in choice of surgical treatment of radial head fracture
Figure 3
Figure 3
Bar chart demonstrating different indications of radial head arthroplasty as opposed to open reduction and internal fixation as per the survey responses
See this image and copyright information in PMC

References

    1. Burkhart KJ, Wegmann K, Müller LP, Gohlke FE. Fractures of the radial head. Hand Clin 2015; 31: 533–546. - PubMed
    1. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 1954; 42: 123–132. - PubMed
    1. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg 1986; 68A: 669–674. - PubMed
    1. Duckworth AD, Watson BS, Will EMet al. . Radial head and neck fractures: functional results and predictors of outcome. J Trauma 2011; 71: 643–648. - PubMed
    1. Unsworth-White J, Koka R, Churchill Met al. . The non-operative management of radial head fractures: a randomized trial of three treatments. Injury 1994; 25: 165–167. - PubMed