A Prospective Study of Functional Outcomes of Radial Head Plating in Radial Head Fractures

Abstract

Background: Radial head fractures are common elbow injuries and are important because the radial head contributes to elbow stability and longitudinal forearm mechanics. Open reduction and internal fixation using anatomically contoured plates has become a preferred option for reconstructable displaced fractures.

Objective: To evaluate the functional and radiological outcomes of radial head plating in adult patients with Mason type II and III radial head fractures.

Materials and Methods: This prospective observational study was conducted over 12 months in the Department of Orthopaedics, Tertiary care hospital, Chennai. Thirty adults with Mason type II and III radial head fractures underwent open reduction and internal fixation using a low-profile radial head plate through the Kocher posterolateral approach. Functional outcome was assessed using the Mayo Elbow Performance Score (MEPS), and radiological outcome was evaluated using the Broberg and Morrey criteria over 1 year of follow-up.

Results: Of the 30 patients, 22 (73.3%) had Mason type II fractures and 8 (26.7%) had Mason type III fractures. At final follow-up, 16 patients (53.3%) had excellent, 9 (30.0%) had good, 4 (13.3%) had fair, and 1 (3.4%) had poor MEPS outcomes. Radiological union was achieved in all patients, with a mean union time of 14 weeks. Excellent or good radiological outcome was observed in 29 patients (96.7%). Younger patients had significantly better functional outcomes than older patients (p = 0.047). Return to activities of daily living was significantly delayed in Mason type III fractures (p = 0.012), and time to union was significantly longer in type III fractures (p = 0.018). Complications were minimal, with one case of postoperative elbow stiffness.

Conclusion: Radial head plating is an effective treatment option for Mason type II and selected type III radial head fractures. It provides stable fixation, reliable union, Excellent functional recovery, and a low complication rate when combined with early mobilization and careful surgical technique..