Skip to main content

Advertisement

Log in

Surgical management of Mason type III radial head fractures

  • Review Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

The evidence for optimal management of Mason type III fracture of radial head is unclear hence a systematic review of the published literature was performed in April 2012. This review includes 5 prospective studies (including 2 randomized trials), 4 retrospective studies and 9 case series. No study can be interpreted as level 1 evidence. Level 2 and 3 evidence provides some insight into the success of each modality through subjective and objective measurements of function and complication rates. Radial head replacement, open reduction internal fixation (ORIF) and radial head resection all provide satisfactory outcomes for patients in most cases. One treatment modality cannot be recommended over any other due to the small number of clinical trials and cases included in each study. Further randomized control trials are needed to evaluate the full benefits and shortcomings of each of the different surgical treatment modalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mason ML. Some observations on fracture of the head of the radius with a review of one hundred cases. Br J Surg 1954;42:123–32.

    Article  CAS  Google Scholar 

  2. Group. OLoEW. The Oxford 2011 Levels of Evidence. Available from: http://www.cebm.net/index/aspx?o=5653. [Last cited in 2011].

    Google Scholar 

  3. Smets S, Govaers K, Jansen N, Van Riet R, Schaap M, Van Glabbeek F. The floating radial head prosthesis for comminuted radial head fractures: A multicentric study. Acta Orthop Belg 2000;66:353–8.

    PubMed  CAS  Google Scholar 

  4. Longo UG, Franceschi F, Loppini M, Maffulli N, Denaro V. Rating systems for evaluation of the elbow. Br Med Bull 2008;87:131–61.

    Article  Google Scholar 

  5. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 2001;83:1201–11.

    Article  CAS  Google Scholar 

  6. Chen XW, Cao LH, Yang GQ, Li M, Su JC. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop 2011;35:1071–6.

    Article  Google Scholar 

  7. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 1986;68:669–74.

    Article  CAS  Google Scholar 

  8. Ruan HJ, Fan CY, Liu JJ, Zeng BF. A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III. Int Orthop 2009;33:249–53.

    Article  Google Scholar 

  9. Koslowsky TC, Mader K, Gausepohl T, Pennig D. Reconstruction of Mason type-Ill and type-IV radial head fractures with a new fixation device: 23 patients followed 1-4 years. Acta Orthop 2007;78:151–6.

    Article  Google Scholar 

  10. Ring D, Quintero JJ. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 2002;84:1811–5.

    Article  Google Scholar 

  11. Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am 2006;88(Suppl 1 Pt l):ll–23.

    Google Scholar 

  12. Janssen RP, Vegter J. Resection of the radial head after Mason type-Ill fractures of the elbow: Followup at 16 to 30 years. J Bone Joint Surg Br 1998;80:231–3.

    Article  CAS  Google Scholar 

  13. Goldberg I, Peylan J, Yosipovitch Z. Late results of excision of the radial head for an isolated closed fracture. J Bone Joint Surg Am 1986;68:675–9.

    Article  CAS  Google Scholar 

  14. Morrey BF, An KN. Biomechanics of the elbow. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders; 1985. p. 43–61.

    Google Scholar 

  15. Iftimie PP, Calmet Garcia J, de Loyola Garcia Forcada I, Gonzalez Pedrouzo JE, Gine Goma J. Resection arthroplasty for radial head fractures: Long term followup. J Shoulder Elbow Surg 2011;20:45–50.

    Article  Google Scholar 

  16. Anturia SA, Sanchez-Marquez JM, Long term results of radial head resection following isolated radial head fractures in patients younger than forty years old. J Bone Joint Surg Am 2010;92:558–66.

    Article  Google Scholar 

  17. Leppilahti J, Jalovaara P. Early excision of the radial head for fracture. Int Orthop 2000;24:160–2.

    Article  CAS  Google Scholar 

  18. Herbertsson P, Josefsson PO, Hasserius R, Karlsson C, Besjakov J, Karlsson M. Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long term followup study. J Bone Joint Surg Am 2004;86:569–74.

    Article  Google Scholar 

  19. Faldini M, Nanni M, Leonetti D, Capra P, Bonomo M, Persiani V, et al. Early radial head excision for displaced and comminuted radial head fractures: Considerations and concerns at long term followup. J Orthop Trauma 2012;26:236–40.

    Article  Google Scholar 

  20. Pelto K, Hirvensalo E, Bostman O, Rokkanen P. Treatment of radial head fractures with absorbable polyglycolide pins: A study on the security of the fixation in 38 cases. J Orthop Trauma 1994;8:94–8.

    Article  CAS  Google Scholar 

  21. Popovic N, Gillet P, Rodriquez A, Lemaire R. Fracture of the radial head with associated elbow dislocation: Results of treatment using a floating radial head prosthesis. J Orthop Trauma 2000;14:171–7.

    Article  CAS  Google Scholar 

  22. Ashwood N, Bain GI, Unni R. Management of Mason type-Ill radial head fractures with a titanium prosthesis, ligament repair and early mobilization. J Bone Joint Surg Am 2004;86:274–80.

    Article  CAS  Google Scholar 

  23. Maripuri SN, Debnath UK, Rao P, Mohanty K. Simple elbow dislocation among adults: A comparative study of two different methods of treatment. Injury 2007;38:1254–8.

    Article  Google Scholar 

  24. Isaack PS, Egol KA. Posttraumatic contracture of the elbow. Bull Hosp Jt Dis 2006;63:129–36.

    Google Scholar 

  25. Nandi S, Maschke S, Evans PJ, Lawton JN. The Stiff Elbow. Hand 2009;4:368–79.

    Article  Google Scholar 

  26. Adams JE, Steinmann SP, Osterman AL. Management of injuries to the Interosseous Membrane. Hand Clin 2010;26:543–8.

    Article  Google Scholar 

  27. Ruch DS, Chang DS, Koman LA. Reconstruction of longitudinal stability of the forearm after disruption of the interosseus ligament and radial head excision (Essex-Lopresti lesion). J South Orthop Assoc 1999;8:47–52.

    PubMed  CAS  Google Scholar 

  28. Morrey BF, Chao EY, Hui FC. Biomechanical study of the elbow following excision of the radial head. J Bone Joint Surg Am 1979;61:63–8.

    Article  CAS  Google Scholar 

  29. Duckworth AD, Watson BS, Will EM, Petrisor BA, Walmsley PJ, Court-Brown CM, et al. Radial head and neck fractures: Functional results and predictors of outcome. J Trauma 2011;71:643–8.

    PubMed  Google Scholar 

  30. Nalbantoglu U, Gereli A, Kocaoglu B, Aktas S, Turkmen M. Capitellar cartilage injuries concomitant with radial head fractures. J Hand Surg Am 2008;33:1602–7.

    Article  Google Scholar 

  31. Duckworth AD, Clement ND, Aitken SA, Ring D, McQueen MM. Essex-Lopresti lesion associated with an impacted radial neck fracture: Interest of ulnar shortening in the secondary management of sequelae. J Shoulder Elbow Surg 2011;20:el9–24.

    Article  Google Scholar 

  32. Bain GI, Ashwood N, Baird RU. Management of mason type-Ill radial head fractures with a titanium prosthesis, ligament repair and early mobilization, surgical technique. J Bone Joint Surg Am 2005;87(Suppl lPt 1):136–47.

    Article  Google Scholar 

  33. Postacchini F, Morace GB. Radial head fracture treated by resection. Long term results. Ital J Orthop Traumatol 1992;18:323–30.

    PubMed  CAS  Google Scholar 

  34. Mikic ZD, Vukadinovic SM. Late results in fractures of the radial head treated by excision. Clin Orthop Relat Res 1983;181:220–8.

    Google Scholar 

  35. Geel CW, Palmer AK. Radial head fractures and their effect on the distal radioulnar joint. A rationale for treatment. Clin Orthop Relat Res 1992;275:79–84.

    Google Scholar 

  36. Jungbluth P, Frangen TM, Muhr G, Kalicke T. A primarily overlooked and incorrectly treated Essex-Lopresti injury: What can this lead to? Arch Orthop Trauma Surg 2008;128:89–95.

    Article  CAS  Google Scholar 

  37. Cooney WP. Radial head fractures and the role of radial head prosthetic replacement: Current update. Am J Orthop 2008;37 (8 suppl):21–5.

    PubMed  Google Scholar 

  38. Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg Am 2004;86:1925–30.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to All Humadi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miller, G., Humadi, A., Unni, R. et al. Surgical management of Mason type III radial head fractures. IJOO 47, 323–332 (2013). https://doi.org/10.4103/0019-5413.114907

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/0019-5413.114907

Key words

Navigation