Radial head fractures: effectiveness of conservative treatment versus surgical intervention. A systematic review.
BACKGROUND
Radial head fractures are common elbow fractures. The Mason classification is used to describe the fracture. As of yet, there is no consensus on optimal treatment strategy for Mason II-IV fractures. The aim of this study was to compare the results of conservative treatment with different surgical strategies for radial head fractures.


METHODS
Electronic databases from 1966 to 2004 were screened. Based on our inclusion criteria, 24 studies, describing 825 patients, were included.


RESULTS
For Mason type II fractures, residual pain was present in 42% of the conservatively treated of the patients compared to 32% of the surgically treated patients. Good/excellent results for Broberg score were 52 and 88%, respectively. For Mason type III and IV fractures, no conservatively treated patients were described.


CONCLUSIONS
There is insufficient evidence to be able to draw definitive conclusions on optimal treatment of type II-IV radial head fractures. Evidence is currently limited to a maximum level II evidence. There is great need for sufficiently powered randomized controlled trials.
Struijs
P A A
PA
Department of General Surgery and traumatology, St. Lucas Andreas Hospital, Frederik Hendrikplantsoen 74-2, 1052 XW Amsterdam, The Netherlands. paastruijs@hotmail.com
Smit
G
G
Steller
E Ph
EP
D006801:Humans; D011885:Radius Fractures / Q000601:surgery / Q000628:therapy*; D020127:Recovery of Function; D016896:Treatment Outcome