One treatment option for Mason type II and type III radial head fractures that cannot be internally fixed includes resection. Complications include proximal migration, stiffness, ulnohumeral arthritis, and valgus instability. This article reports on 26 patients under the age of 40 years old whom radial resection was performed.
Mean follow up on these patients was 25 years. Pain was completely relieved in 21/26 pts. Three patients complained of wrist pain and showed proximal migration of the radius on radiographs of the wrist. There was an average of 3.1 mm of radial shortening at the wrist. Mean range of motion was 9°-139° flexion to extension arc; 84° pronation and 85° supination. Average grip strength was 39 kg on the injured side and 45 kg on the contralateral side. All patients had evidence of radiographic arthritis, but there was no correlation with functional impairment. The average DASH score was 6.
This article reviews a long term follow-up of young patients in whom radial head resection was performed for Mason II and III fractures. Overall over 90% of the patients presented had a good result with improvement of pain and little loss of function. The authors conclude that radial head resection as a viable option with long term good results in the treatment of radial head fractures. This article goes against the current rend to replace rather than resect the radial head. However, one cannot argue with the follow-up reported in this study.