[Treatment of displaced radial head fractures with internal fixation].

Objective: To analyse the procedure and effectiveness of internal fixation in treatment of displaced radial head fractures.

Methods: Between August 2005 and May 2009, 35 patients with displaced radial head fractures underwent open reduction and internal fixation with Smart Nail and/or AO mini-plates. There were 28 males and 7 females with an average age of 28.4 years (range, 17-48 years). The injury mechanism included traffic accident in 16 patients, falling in 13, and falling from height in 6. According to Mason classification, 21 fractures were rated as type II, 9 as type III, and 5 as type IV. All fractures were closed fractures. Six cases complicated by radial neck fractures, 1 case by olecranon fracture, 3 by posterior dislocations of the elbow, 1 by posterior dislocation of the elbow and coronoid process fracture, and 3 by medial collateral ligament injuries. The time from injury to operation was 3 to 7 days.

Results: Except 1 patient whose incision healed by second intention, healing of incision by first intention was achieved in the other patients. All patients were followed up 12-25 months with an average of 17 months. The average fracture healing time was 10.2 weeks (range, 8-16 weeks). At last follow-up, the average flexion and extension of the elbow was 119 degrees (range, 95-145 degrees). The average arc of forearm rotation was 126 degrees (range, 90-175 degrees). According to elbow functional evaluation criteria by Broberg and Morrey, the results were excellent in 18 cases, good in 13, and fair in 4; the excellent and good rate was 88.6%.

Conclusion: In treatment of displaced radial head fractures, open reduction and internal fixation can be performed with Smart Nail and/or AO mini-plates based on different fracture types and the short-term effectiveness is satisfactory.