Vol. 10, Issue 4 (2024)

Introduction: The radial head is an important component that enables for the elbow’s natural stable mobility through a synergistic link between a bony base and its surrounding soft tissue. Over the last three decades, our growing understanding of the elbow has offered invaluable insight into the complexities of a complex diarthrodial joint. This study aims to assess the clinical outcome of excision arthroplasty and prosthesis replacement in treatment of comminuted radial head fractures.

Methods: This study was an observational comparative study carried out in the Department of Orthopedic Surgery, BSMMU, Dhaka, Bangladesh from July to December 2023. Total 60 cases of radial head fractures who were treated with radial head replacement and radial head excision. Patients with radial head fracture presenting to orthopaedics department and emergency room. The functional outcome of both the procedure was compared using DASH, MEPS and Broberg and morrey scoring system.

Results: Among 60 cases 30 underwent Radial Head Replacement and 30 were treated with radial head excision. Regarding occupation in our study, we observed daily wages, sports person, students, farmer etc. Based on the DASH score Replacement group showed good improvement at the end of the 6^th month follow-up with the mean score of 15.9 (P=0.042). Based on the MEPS score the mean MEPS score showed replacement group had a good improvement at the end of 6th month follow-up with the mean score of 15.9 (P=0.042).

Conclusion: From this study we concluded, radial head replacement is a reasonable option for unreconstructable radial head fractures. Radial head replacement can achieve effective radiocapitellar contact that will improve the stability in valgus, posterolateral, and axial loading of the forearm. This treatment option has satisfactory short- and mid-term results even with other combined elbow injuries.