[The results of open reduction and internal fixation of radial head fractures].

Objectives: We evaluated the results of radial head fractures treated with open reduction and internal fixation.

Methods: Fifteen patients (9 men, 6 women; mean age 38 years; range 23 to 46 years) underwent open reduction and internal fixation for radial head fractures. According to the Mason classification system, the fractures were type II in seven patients, type III in five patients, and type IV in three patients. Accompanying fractures involved the coronoid process (n=3), olecranon and coronoid process (n=1), scaphoid and coronoid process (n=1), scaphoid with perilunate dislocation (n=1), and the capitellum (n=1). One patient had a Colles' fracture. Osteosynthesis was performed with an AO small plate in nine patients and with a screw in six patients. Bone grafts taken from the distal part of the radius were used in five patients. Clinical and radiographic evaluations were made with the use of a modified Morrey functional evaluation index. The mean follow-up period was 26.4 months (range 14 to 53 months).

Results: Functional results were excellent in six elbows, good in three elbows, and moderate in three elbows. Pseudoarthrosis of the radius head was encountered in three patients. Reductions were assessed as anatomic in 12 patients, good in two patients, and poor in one patient.

Conclusion: In the treatment of radial head fractures, the anatomic integrity of the radius head should be preserved in order to maintain the biomechanics of the elbow. Following a meticulous treatment plan and with preservation of the lateral ligament anatomy, osteosynthesis performed in a safe zone and achievement of a stable elbow may provide successful results in the treatment of radial head fractures.