The outcome comparison of arthroplasty and ORIF for Mason type III radial head fractures

Many controversies still exist with regard to surgical treatment of Mason type III fractures. In this study, we compared the mid-term clinical outcomes of radial head arthroplasty (RHA) and open reduction-internal fixation (ORIF) for treating Mason type III radial head fractures. From 2006 to 2012, 55 patients with Mason type III fractures were retrospectively included and divided into RHA group and ORIF group. Range of motion (ROM) was evaluated at 3rd, 6th and 12th month post-operatively. Functional recovery assessment using Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand score (DASH), Visual analog score (VAS) were reviewed at the last follow-up. The risk factors influencing outcomes following surgery were analysed using logistic regression. Every patient received a minimum of 2 years-follow-up. No significant differences were in complication rate, VAS and DASH between RHA and ORIF. Better ROM of elbow joint and higher MEPS were achieved in RHA group. Through logistic regression analysis, concomitant injuries, RHA, ORIF and age were not independent risk factors influencing outcomes following surgery. Our findings demonstrated that RHA was superior to ORIF on elbow function in treating Mason type III radial head fractures at mid-term follow-up, but RHA alone was not a guarantee of better clinical outcomes.