Radial head resection versus replacement for unreconstructable radial head fractures

Abstract

Radial head resection and replacement are common treatment strategies for comminuted radial head fractures. In particular, the presence of more than three fragments in the setting of unstable radial head fracture has a poor prognosis and, if secure fixation cannot be achieved, radial head resection or replacement may be the best option [1]. Although the indications are controversial, radial head resection without replacement has been recommended in isolated unreconstructable radial head fractures when the degree of comminution hinders internal fixation, especially for those who have little demand [2]. In this issue, a study by Mebouinz et al. [3], "Results of radial head resection after mason type 3 or 4 fracture of the elbow, " discusses 11 patients treated with radial head resection for a comminuted radial head fracture for which internal fixation was not possible. They reported that nine patients had a stable and painless elbow with an average follow-up of 47.6 months. The extension-flexion arc ranged from 5° to 120° and the mean values of pronation and supination were 76.8° and 74.5°, respectively. The mean Mayo Elbow Performance Score was 83.2 points and recovery of overall function of the elbow was achieved in 81% of cases. They concluded that radial head resection remains a useful surgical procedure for radial head fractures. However, this study should be interpreted with caution. The