Early radial head excision for displaced and comminuted radial head fractures:  considerations and concerns at long-term follow-up.
OBJECTIVE
The aim of this study is to retrospectively review the outcomes of patients with comminuted radial head fractures surgically treated with early radial head excision.


METHODS
Retrospective follow-up study.


METHODS
University orthopaedic trauma center.


METHODS
Forty-two patients with unilateral, isolated, closed, displaced, or comminuted radial head fracture (Mason type 2-10, Type 3-32).


METHODS
Early radial head excision.


METHODS
Patients were clinically and radiographically evaluated at an average follow-up of 18 years. The uninjured contralateral limb was used as a comparison. Clinical evaluation was rated using the Broberg and Morrey system, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and the visual analog scale (VAS) for pain.


RESULTS
At last follow-up, 36 patients had no complaints, whereas six admitted to occasional pain. The mean Broberg and Morrey score was 91.2 ± 6.3, and the mean Disabilities of the Arm, Shoulder and Hand score was 10.1 ± 8.8.


CONCLUSIONS
Early radial head excision represents a viable option in case of displaced and comminuted fractures. According to the results of this study, it demonstrated a high rate of good results and patient satisfaction, a quick recovery after surgery, and a low rate of complications with durable results at long-term follow-up.


METHODS
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy. cesare.faldini@ior.it
Cesare
C
Faldini
Matteo
M
Nanni
Danilo
D
Leonetti
Paola
P
Capra
Marco
M
Bonomo
Valentina
V
Persiani
Claudio
C
Galante
Sandro
S
Giannini
D000293:Adolescent; D000328:Adult; D005260:Female; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000175:diagnosis* / Q000601:surgery*; D017759:Fractures, Malunited / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011885:Radius Fractures / Q000175:diagnosis* / Q000601:surgery*; D020127:Recovery of Function; D016896:Treatment Outcome