Radial head fractures often occur in association with other elbow fractures
and soft-tissue injuries. Radial head replacement is indicated for irreparable
radial head fractures associated with elbow instability. The purpose of this
study was to analyze the results after treatment of such injuries with a
titanium radial head prosthesis, repair of torn collateral ligaments, and
early mobilization of the elbow.
Sixteen patients with sixteen Mason type-III radial head fractures and
collateral ligament injury were treated with use of a titanium radial head
prosthesis over a five-year period at the Royal Adelaide Hospital and Modbury
Public Hospital in South Australia. The surgery was performed acutely in ten
patients and was delayed an average of thirty-seven days (range, fifteen to
seventy-nine days) in six. All patients were followed clinically and
radiographically for a mean of 2.8 years (range, 1.2 to 4.3 years).
Eight patients had an excellent result; five, a good result; and three, a
fair result, according to the Mayo Elbow Performance Score. The three fair
results occurred in patients with delayed surgery. The mean flexion
contracture was 15° (range, 0° to 42°), with an average loss of
10° (range, 0° to 25°) of full flexion compared with that of the
contralateral elbow. Both pronation and supination decreased an average of
12° (range, 0° to 45°) compared with that of the contralateral
The results of treatment of Mason type-III radial head fractures with a
monoblock titanium radial head prosthesis and soft-tissue reconstruction are
satisfactory. Early mobilization of the elbow is important for the restoration
of elbow range of motion and function.