Abstract: Radial head fractures are the most frequent fracture type reported around the elbow. Fractures have been documented to occur in isolation or with other associated osseous and soft tissue injuries, with awareness for the potential patterns of injury essential in determining the appropriate management to attain restoration of elbow function. Radial head fractures are seen in 33% of elbow fractures. It may involve the radial head, radial neck or both. Treatment depends on the type of fracture, amount of displacement, comminution and associated injuries. Previously radial head excision was a popular treatment, now it is being replaced by open reduction and internal fixation or radial head replacement. The assessment of these common fractures and treatment have evolved with better understanding of the anatomy and biomechanics of radial head and the development of evidence based guidelines.
Aim and Objective: To study the clinical and functional outcome of radial head fractures managed conservatively and by mean of internal fixation and by mean of radial head excision.
Material and Methods: For prospective study Sample will be taken from the patients treated in P.D.U. Medical College and Hospital having radial head fracture on basis of plain radiograph and CT scan, classified according to Mason classification and treatment plan will be decided accordingly. Results will be assessed on basis of functional classification system at 1 month, 3 months and 6 months.
Results: In Our study of 60 cases, 30 patients having a Mason type 1 variety radial head fractures treated conservatively by mean of plaster application and 26 patients of Mason type 2 radial head fracture treated by mean of open reduction and internal fixation and 4 patient of Mason type 3 radial head fracture treated by mean of excision. Out of all the patients treated by different modality 20% of patients present with stiffness of elbow joint and 2% of patients presented with infection.
Conclusion: From our objective, functional assessment perspective open reduction internal fixation of radial head fracture when technically possible appears to be provide function superior to excision. Furthermore open reduction and internal fixation provides results similar to those obtained in less severe injuries where non-operative management is possible. Such improvement results from preservation of anatomy with maintenance of the normal load bearing characteristic of elbow joint.
