Results of delayed excision of the radial head after fracture.

TLDR

Twenty‑one patients underwent delayed excision of a fractured radial head (1 month–>20 years post‑fracture), including 4 Mason II and 17 Mason III injuries, some with dislocations or ulnar fractures, and were evaluated for pain, motion, strength, stability, and function over an average 15‑year follow‑up. Postoperatively, 76 % of patients reported less pain, 81 % had improved flexion and rotation, and 77 % achieved good or excellent functional outcomes, supporting delayed excision after failed closed management of radial head fractures.

Abstract

Twenty-one patients had a delayed excision of a previously fractured radial head (range, one month to more than twenty years). There were four Mason type-II and seventeen Mason type-III fractures. Five fractures had been associated with a concomitant dislocation of the elbow and four, with an ulnar fracture. All of the patients were evaluated for pain, motion, strength, stability, and function by personal interview, examination, and testing in an upper-extremity-biomechanics laboratory. The average length of follow-up was fifteen years (range, three to thirty-two years). Postoperatively, pain was less severe in 76 per cent of the patients and motion was improved in both flexion and rotation in 81 per cent. An objective functional index showed that 77 per cent of the patients had a good or excellent result while 23 per cent had a fair or poor result. This study demonstrates the effectiveness of delayed excision after failure of closed management of fractures of the radial head. Thus, some justification is offered for the initial closed treatment of these fractures, with delayed excision of the radial head to be considered as needed.