title: Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis.
abstract: OBJECTIVE
  Open reduction and internal fixation (ORIF) and radial head arthroplasty (RHA) are the most common operative treatments in patients with radial head fractures. The purpose of this study was to determine the efficacy of RHA and ORIF treatments in patients with radial head fractures (modified Mason type III and IV).
  
  
  METHODS
  We conducted a computerized search of five electronic databases from their inception to July 2015. All clinical trials comparing ORIF versus RHA treatment in patients with radial head fractures were included. We evaluated the primary outcomes included elbow functional evaluation criteria by Broberg and Morrey, elbow score (Broberg and Morrey), Mayo Elbow Performance Score (MEPS) and QuickDASH score. Secondary outcomes included Visual Analog Scale (VAS), range of motion, operation time and complications. The "assessing risk of bias" table was applied to assess the risk of bias of the included studies.
  
  
  RESULTS
  Eight studies were included in this meta-analysis, which consisted of 138 cases of ORIF and 181 RHA. Methodological quality of the studies was moderate to low. RHA afforded significantly higher satisfaction rate, better elbow score (Broberg and Morrey) and MEPS, shorter operation time, lower incidence of bone nonunion or absorption and internal fixation failure when compared to ORIF. There were no significantly differences in QuickDASH score and other complications.
  
  
  CONCLUSIONS
  RHA has better outcome in patients with radial head fractures (modified Mason type III and IV) than ORIF with medium-short-term follow-up period, but longer-term studies will be required to ascertain whether the apparent benefits of RHA were offset by late complications.
  
  
  METHODS
  Therapeutic decision analysis; a meta-analysis, Level III.
authors.affiliation: Department of Orthopedics, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of JiNan University, 396 Tong Fu Zhong Road, Guangzhou, 510220, Guangdong, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Orthopedics, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of JiNan University, 396 Tong Fu Zhong Road, Guangzhou, 510220, Guangdong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Duan
authors.affiliation: Department of Orthopedics, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of JiNan University, 396 Tong Fu Zhong Road, Guangzhou, 510220, Guangdong, China. fslijnu@qq.com.
authors.forename: Fengsheng
authors.initials: F
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D000070799:Open Fracture Reduction / Q000379:methods; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: Meta-analysis; Radial head arthroplasty; Radial head fixation; Radial head fracture; Terrible triad injuries