Operative vs. nonoperative treatment for Mason type 2 radial head fractures: a randomized controlled trial

Mulders, Marjolein A. M.; Schep, N.W.L.; Keizer, Robert-Jan O. de Muinck; Kodde, Izaäk F.; Hoogendoorn, J. M.; Goslings, J. Carel; Eygendaal, Denise

doi:10.1016/j.jse.2021.02.025

Cited by 14 publications

(7 citation statements)

References 29 publications

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“…However, the incision length was dramatically smaller in Group A. In the follow up, the patients in Group A achieved satisfactory results comparable to that in Group B when evaluated by MEPS, DASH, VAS scales and ROM, and the results were similar to those of other studies [ 4 , 11 , 16 , 17 ]. The common postoperative complications of ORIF include elbow stiffness, traumatic arthritis, heterotopic ossification, necrosis, bone ununion, broken/loosen of the implants, et al This study showed that the total complication (stiffness, local pain/discomfort) rate was lower in Group A, which was probably attributed to the mini-invasiveness of this technique and the mini-size of this system.…”

Section: Discussionsupporting

confidence: 81%

“…Mason II fractures are defined as displaced fractures (displacement, > 2 mm) of the radial head or neck without comminution, that are amenable to open reduction and internal fixation (ORIF) [ 3 ]. However, Mulders et al reported that non-operatively treated adults with an isolated Mason II radial head fracture had similar functional results after one year compared to operatively treated patients [ 4 ]. For Mason III, the ORIF or arthroplasty is mostly recommended [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of radial head fractures treated with pre-curved metacarpal plate

Yang,

Zhuang,

Xiaosong

et al. 2023

BMC Musculoskelet Disord

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Objective To explore the clinical outcomes of MasonII/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates. Methods Ninety cases of Mason typeII/III radial head fractures without the neck involvement were retrospectively collected from the department of orthopaedics of our hospital from September 2015 to May 2021. Group A (n = 44) underwent open reduction and internal fixation with pre-curved metacarpal plate, and Group B (n = 46) were fixed by traditional T-shaped plates. The operation time and the incision length were recorded during the operation. The Mayo Elbow Performance Score (MEPS), Disability of Arm, Shoulder and Hand (DASH) score, visual analogue scale (VAS) for pain, range of motion (ROM) and post-operative complications were evaluated at the last follow-up. Results All the patients were followed up for at least 12 months. There were no significant difference between two groups regarding operation time (54.2 ± 12.1 v.s 51.3 ± 7.2, mins), MEPS (88.9 ± 4.2 v.s 87.8 ± 4.4), DASH score (7.3 ± 4.6 v.s 9.0 ± 4.0), VAS (1.6 ± 0.8 v.s 1.7 ± 0.7), and ROM. However, the incision length was shorter in Group A (5.6 ± 0.5 v.s 6.6 ± 0.5, cm, P < 0.01). The postoperative complication rate was also lower in Group A (1/44 v.s 8/46, P = 0.02). Conclusion Masson II/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates could achieve satisfactory outcomes comparable to traditional T-shaped plates. Moreover, the invasiveness and postoperative complications are less in patients with pre-curved metacarpal plates. Level of evidence III, retrospective comparison study.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Outcomes of radial head fractures treated with pre-curved metacarpal plate

Yang,

Zhuang,

Xiaosong

et al. 2023

BMC Musculoskelet Disord

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“…There are several studies investigating the outcome after radial head fractures. Nevertheless, most studies only compare different treatment options for the same fracture type according to the Mason classification [ 7 , 11 , 15 , 16 , 17 ]. Sufficient data about the functional outcome comparing different Mason fracture types are still lacking in the current literature.…”

Section: Discussionmentioning

confidence: 99%

Functional Postoperative Outcome for 92 Cases of Radial Head Fractures: A PROM-Based Retrospective Study

Müller,

Mann,

Zapf

et al. 2023

JCM

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Background: Fractures of the radial head are common injuries, whereas, in the case of displaced fractures, surgical treatment using screw or plate osteosynthesis, excision, or replacement of the radial head is required. However, data about patient-related outcomes (PROM) for different types of radial head fractures is limited in the current literature. Therefore, this study was conducted to evaluate the functional outcome after operatively treated radial head fractures and to further correlate these results with the initial modified Mason classification. Methods: In this retrospective study, all suitable patients with surgical treatment of a radial head fracture were identified. Only patients with Mason II-IV fractures were included. All patients completed the Elbow Self-Assessment Score (ESAS) questionnaire. Data on fracture classification, type of surgery, and revision operations (if needed) were assessed. Results: A total of 92 patients suffering from fractures of the radial head (57 Mason II, 35 Mason III-fractures) who were operatively treated at our institution were enrolled. There were 42 (47.7%) female and 50 (54.3%) male patients with an average age of 47.5 ± 14.1 years. Screw osteosynthesis was performed in 67 patients, plate osteosynthesis in 20 patients, and five patients received radial head arthroplasty. The average ESAS score accounted for 89.7 ± 16.7. Mason II fractures showed significantly better functional results with higher ESAS scores (92.3 ± 13.9 vs. 85.4 ± 20.1) as well as significantly lower rates of necessary implant removal (0 vs. 5 (14.3%) than Mason III fractures. Screw osteosynthesis showed significantly better functional ESAS scores, 91.0 ± 16.5, than plate osteosynthesis, with 85.3 ± 17.6 (p = 0.041), but was predominantly used in Mason II fractures. Conclusions: Surgical treatment using screw- and plate osteosynthesis of radial head fractures provides a good overall outcome. The postoperative function is associated with the initial Mason classification as the patients’ reported outcome was worse in Mason III fractures compared to Mason type II fractures. In this context, the ESAS score can be considered a useful tool for the assessment of the patient-based functional outcome.

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“…The treatment of Mason type-2 radial head fractures is controversial. A multicenter randomized trial (RAMBO [Radial Head – Amsterdam – Amphia – Boston – Others]) 6 of isolated fractures was conducted in 45 patients with a median age of 50 years; 22 patients underwent open reduction and internal fixation (ORIF) with screw fixation, and 23 patients had nonoperative treatment. Exercise instructions were provided.…”

Section: Distal Part Of the Humerus And Elbowmentioning

confidence: 99%