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DOI: 10.1055/s-0028-1100850
Displaced radial head fractures
Operative versus nonoperative treatmentPublication History
Publication Date:
30 April 2009 (online)
Summary
Evidence is poor from four small retrospective cohort studies comparing operative treatment of Mason type II radial head fractures with nonoperative methods. More recent studies that utilized open reduction and internal fixation (ORIF) as an operative treatment demonstrated better functional results compared with nonoperative treatment. In contrast, older studies that utilized excision of the radial head as an operative treatment reported poorer results compared with nonoperative treatment. Better outcomes following ORIF are suggested based on indirect comparison with excision results, however, this needs to be formally evaluated via studies directly comparing these two methods. Evidence-based conclusions are difficult given the small sample sizes, uneven distribution of patients into treatment groups, and selection of treatment based on patient presentation (confounding by indication). A methodologically rigorous, multicenter randomized controlled trial may provide sufficient sample size to effectively compare treatments for Mason type II fractures.