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      Comparison of Primary Radial Head Replacement and ORIF (Open Reduction and Internal Fixation) in Mason Type III Fractures: A Retrospective Evaluation in 72 Elderly Patients

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          The aim of this study was to compare radial head prosthesis replacement with open reduction and internal fixation (ORIF) in the surgical treatment of Mason type III radial head fractures in 72 elderly patients.


          Seventy-two elderly patients (mean age, 67.1±1.25 years, range, 62–81 years) with Mason type III radial head fractures were treated from January 2001 to June 2012. Of these, 37 cases received radial prosthesis and 35 cases were treated with ORIF. All patients were followed up for 10 to 15.6 months.


          Based on the elbow functional evaluation criteria score by Broberg and Morrey, 29 cases achieved excellent results, 7 were good, and 1 was fair in the replacement group. In the ORIF group, excellent results were seen in 24 cases, good in 9, and fair in 2. The rates of good or excellent results were 78.4% and 68.6% for prosthesis replacement patients and ORIF patients, respectively ( P<0.05). The Visual Analogue Scores (VAS) for replacement and ORIF groups were 2.25 and 1.67, respectively ( P<0.05).


          The radial head prosthesis replacement method is a relatively better surgical approach than ORIF in the treatment of elderly patients with Mason type III radial head fractures.

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          Most cited references 12

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          Some observations on fractures of the head of the radius with a review of one hundred cases.

           Susan Mason (1954)
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            Results of delayed excision of the radial head after fracture.

             B Morrey,  M L Broberg (1986)
            Twenty-one patients had a delayed excision of a previously fractured radial head (range, one month to more than twenty years). There were four Mason type-II and seventeen Mason type-III fractures. Five fractures had been associated with a concomitant dislocation of the elbow and four, with an ulnar fracture. All of the patients were evaluated for pain, motion, strength, stability, and function by personal interview, examination, and testing in an upper-extremity-biomechanics laboratory. The average length of follow-up was fifteen years (range, three to thirty-two years). Postoperatively, pain was less severe in 76 per cent of the patients and motion was improved in both flexion and rotation in 81 per cent. An objective functional index showed that 77 per cent of the patients had a good or excellent result while 23 per cent had a fair or poor result. This study demonstrates the effectiveness of delayed excision after failure of closed management of fractures of the radial head. Thus, some justification is offered for the initial closed treatment of these fractures, with delayed excision of the radial head to be considered as needed.
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              Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes.

              Comminuted fractures of the radial head are challenging to treat with open reduction and internal fixation. Radial head arthroplasty is an alternative treatment with results that compare favorably with those reported after open reduction and internal fixation of similar fractures. The purpose of this study was to evaluate the two-year outcomes and the rate of recovery of a closely followed cohort of patients in whom an unreconstructible radial head fracture had been treated with a modular metallic prosthesis.

                Author and article information

                Med Sci Monit
                Med. Sci. Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                08 January 2015
                : 21
                : 90-93
                Department of Orthopedics, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
                Author notes
                Corresponding Author: Ming Cai, e-mail: cmdoctor@

                Study Design


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                These authors contributed equally to this work

                © Med Sci Monit, 2015

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License

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