Open Reduction and Internal Fixation of Complex Radial Head Fractures

Fractures of the radial head have an incidence of about 1.7% to 5.4% of all adult fractures. These fractures are classified as simple or complex, depending upon whether there is an associated fracture or a ligamentous injury. Thorough clinical & radiological assessment should be done to differentiate simple fractures from complex fractures with concomitant elbow injury. The management of complex radial head fractures remains controversial including radial head excision, open reduction & internal fixation and radial head replacement. The aim of this study is to assess the possibility and review the results of open reduction and internal fixation of complex radial head fractures. Twelve patients with complex radial head fractures underwent open reduction and internal fixation during the period from 2006 to 2009. The overall outcome was rated using Mayo Elbow Performance Score. Excellent results were achieved in 5 cases 41.5%; good in 6 cases 50%; % fair in one case 8.5% and no poor results. No infection, skin complications or heterotropic ossification in all cases. We conclude that, in such complex injuries, preservation of radial head by open reduction and internal fixation is mandatory together with appropriate treatment of concomitant injuries to regain the elbow stability for better outcomes.