Late results of excision of the radial head for an isolated closed fracture

Abstract

A retrospective study was undertaken of twenty patients with a Mason type-II and sixteen patients with a Mason type-III closed fracture of the radial head who had excision of the radial head. The average length of follow-up was 16.4 years (range, three to twenty-seven years) and the average age of the patients at operation was forty-two years (range, eighteen to seventy-five years). Thirty-one patients (86 per cent) were satisfied with the results, and thirty-four (94 per cent) returned to their preoperative occupations. Only three patients lost 30 degrees or more of flexion of the elbow or of pronation or supination of the forearm. A measurable proximal migration of the radius of more than one millimeter was found in eight patients (22 per cent), but no harmful effects of this were found. All of the patients showed osteoarthritic changes on roentgenograms of the elbow that had been operated on, but these did not affect the functional scoring. According to the functional classification that we used, thirty-three (92 per cent) of the patients were able to function satisfactorily in activities of daily living and only three were not. We concluded that if, for any reason, operative treatment is undertaken for these fractures, good functional results can be expected. Nevertheless, because the results of non-operative treatment of Mason type-II fractures, as reported in the literature, have been almost identical to ours, we have adopted a non-operative approach in the last few years.