Prosthetic Replacement of Radial Head in Surgical Management of Fractures Radial Head

Objectives: To show the results of a limited surgical protocol in treating Mason type III radial head fracture isolated or associated with fractures of the proximal ulna or elbow dislocations , especially if the medial collateral ligament is disrupted , including replacement of the unfixable comminuted fractured head of radius and repair of the lateral collateral ligament (LCL) and lateral ulnar collateral ligament (LUCL). Design: Retrospective study Setting: Department of Orthopedic, Sohag University Hospital, Egypt Subjects: Twenty patients with Mason type III radial head fracture or fracture dislocation radial head ( Mason type VI ) . Intervention: Surgical protocol of replacement of comminuted unfixable fractured head of radius, repair of LCL, LUCL injuries and short elbow immobilization in a plaster splint followed by physiotherapy . Main Outcome Measure: Mayo score on four parameters ( pain , motion , stability and function ) was calculated, and clinical and radiological complications were assessed[1] . Results: Sixteen patients ( 80 % ) excellent, two good, one fair and one poor . The average cumulative Mayo score was 93.5/100 . No patients developed re-dislocation post-surgically. Radiological results showed no case had secondary post-traumatic osteo-arthrosis or prosthesis breakage or loosening . Conclusion: Operative management as described above can achieve elbow stability, functional range of motion and minimal complications without the need to repair the the medial collateral ligament ( MCL) or to use hinged external fixator or cross- pinning .