Functional Outcomes After Open Reduction and Internal Fixation of Type II and Type III

Abstract Background: Surgically repairing radial head fractures through open reduction and internal fixation (ORIF) can pose challenges, making radial head resection a recognized treatment option. Objective: In this research, we examined the outcomes of various methods employed in radial head resection and contrasted them with those of ORIF in individuals experiencing a compressed radial head fracture. Materials and Methods: Twenty-one individuals aged 18 years and above, diagnosed with Mason type II and III radial head fractures, participated in this study. Among them, 14 patients received radial head resection through ORIF employing Herbert screw and K-wire, four underwent L-plate and K-wire fixation, while three underwent mini-T-plate fixation. The evaluation of functional outcomes was conducted using the Broberg and Morrey rating system at 1–3 months postsurgery and again at the 6-month mark. Parameters such as pain level, range of motion, muscle strength, and joint stability were meticulously measured during the assessments. Results: In our study, we found that out of 15 patients, 1 patient had a satisfactory outcome while 4 patients had fair outcomes and 1 patient had a poor outcome. The mean functional index was 81.9 points and the mean range of movement at the elbow was 8°–116° (normal arc is 0°–135°) for flexion. The mean pronation was 58° (normal 60°) and the mean supination was 43° (normal 70°). Arm strength was significantly improved at 3 months in all surgical groups. Pain was moderate in all groups and gradually reduced up to 6 months. Conclusion: ORIF with T-plate, L-plate, or Herbert screw in radial fracture resulted in similar outcomes. Each of these methods leads to adequate joint mobility and offers superior strength and overall functional improvement compared to radial head resection. However, a comparison with conventional methods (such as plaster) is recommended. Level of Evidence: Prospective cohort comparison; surgery outcome.