![]() Patients were clinically and radiographically followed-up at a mean time of 36 months from injury (range 24 to 60 months).Ĭlinical evaluation was carried out by two different authors and the mean of each parameter was recorded in order to minimize intraobserver bias. Immobilization was followed by rehabilitation including both passive and active movements of the elbow, of the forearm and of the wrist in all patients. The fracture was caused by a low energy trauma (defined as a fall or a direct impact) in 37 patients whereas 15 patients had a high energy trauma (defined as a motor-vehicle accident or a fall from > 2 m).Ī long arm cast with the elbow 90° flexed and the forearm in neutral rotation was applied to all patients for two weeks. The dominant limb was affected in 33 patients, whereas the non dominant limb was affected in 19 patients. The mean age at the time of fracture was 28.1 years ± 7.5 (range 13 to 48). Twenty patients were not enrolled in the study because of inability to be contacted or refusal to be included.ĭemographic data were recorded. Out of 72 patients that met the inclusion criteria, 52 patients (31 males, 21 females) were enrolled in the study. Exclusion criteria were: Mason type II fractures associated with other elbow fractures (coronoid apophysis, olecranon, lateral and medial epicondyle), elbow dislocation, ligament injuries, vascular injuries or nerve injuries. The following inclusion criteria were established: 1) Mason type II fractures (2–5 mm of displacement), as shown on anteroposterior and lateral radiographs of the elbow taken at the time of injury and before treatment 2) isolated fractures 3) nonsurgical treatment 4) all patients were involved in sports activities at different levels. However mid and long-term follow-up have demonstrated that nonsurgical treatment can provide a good or excellent functional outcome in the vast majority of cases ( 24, 25).Ī retrospective chart review was performed on athletes who were diagnosed a radial head fracture during the period between 20. In recent years, the improvement of surgical techniques (new instrumentation and implants) has made open reduction and internal fixation (ORIF) increasingly popular ( 22, 23). Historically, the treatment of choice for Mason Type II fractures was radial head excision after failure of conservative treatment ( 20, 21). The best treatment of type II fractures having no association with other fractures or ligament injuries (known as isolated fractures) is still debated. For Mason type III fractures potential treatment modalities include open reduction and internal fixation, radial head excision, or radial head replacement ( 16– 19). It is generally agreed that type I fractures can be successfully treated non operatively with early mobilization ( 11– 15). Broberg and Morrey ( 8) modified Mason’s classification, quantifying displacement of 2 mm or greater as articular step-off or gap, and indicating that fracture fragments representing less than 30% of the articular surface should not be considered type II. Comminuted articular fractures involving the whole head of the radius are Mason type III fractures. Type II fractures are articular fractures involving a part of the head with displacement. A Mason type I fracture is a fissure or marginal sector fracture without displacement. Several classifications ( 6– 10) have been introduced to describe radial head fractures, nearly all derived from the classification proposed by Mason in 1954 ( 6). They may be isolated or associated with more complex injuries such as fractures of the olecranon or coronoid process, elbow dislocation, ligament rupture, vascular injuries or nerve injuries ( 4, 5). ![]() They generally occur after a fall on the outstretched arm. Radial head fractures are common, accounting for approximately one-third of all elbow fractures, with an estimated incidence of 2.5 to 2.9 per 10.000 people per year ( 1– 3). ![]()
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