A Prospective Study on Short-term Clinic-radiological Outcomes of Radial Head Arthroplasty in Treatment of Isolated Closed Comminuted Radial Head Fractures

Background: This study aims to understand the outcomes of Mason type 3 and type 4 unrepairable radial head fractures using a modular metallic radial head prosthesis conducted in Eastern India. Materials and Methods: The study is a prospective observational descriptive one in level III institutional settings with the objectives to identify functional and radiological outcomes. Eighteen adults (male = 7, female = 11) of isolated Mason type 3 in 12 and Mason type 4 in 6 participants of mean age 40.11 years (range: 26–58) are included. Results: Distribution of Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) and Quick DASH score at 4 months follow-up were 25.78 (range: 16.3–38.6, standard deviation [SD] 6.25) points and 24.62 (range: 15.6–37.3, SD: 6.19, P = 7.79871E-07) points, respectively, whereas those at 8 months reduced to 20.58 (range: 11.6–30.3, SD: 6.01, P = 3.58555E-07) and 20.184 (range: 11.3–29.7, SD: 5.82, 7.79871E-07), respectively. The Mayo Elbow Performance Score at 4 and 8 months was 63.39 (range: 42–78, SD: 10.42) and 79.72 (range: 95–55, SD: 10.64, P = 1.48162E-14) points, respectively. The overall clinical results of both DASH and Quick DASH were excellent in nine (50%), good in three (16.67%), fair in five (27.78%) and poor in one (5.56%). All cases had capitellar osteopenia at 4 and 8 months. Other complications were non-bridging heterotopic ossification in seven (38.89%), without causing restriction of movements, and overlengthening. No patient had stem loosening at 8 months. Conclusion: In non-repairable radial fractures in adults, replacement of the radial head with a bipolar metallic implant is an option.