Radial head fractures: review of current evidence about assessment, classification and management

The radial head fractures are frequent elbow injuries with several fracture patterns and associated lesions. The literature highlights the importance of correct patient management right from the earliest stages to achieve the best results and to avoid complications. The purpose of this article was to provide an overview of current concepts of the management of radial head fractures. The main goal of each treatment should be to restore elbow biomechanics, kinematics and stability to achieve a complete range of motion and to early begin rehabilitation programs. For Mason type 1 fractures the nonoperative management is the best choice providing good or excellent results in most patients. There is less agreement regarding Mason type 2 fractures, in term of nonoperative or surgical treatment. When surgical treatment is chosen, open reduction and internal fixation seems to guarantee the best clinical outcomes with excellent results reported. The Mason type 3 or 4 fractures are managed with surgical treatment. However, the best method of treatment remains controversial in literature between open reduction and internal fixation, radial head arthroplasty and radial head excision. In the last years, arthroscopy is going to assume an important role in the management of elbow diseases, not only as diagnostic tool but also as surgical solution and probably in the future its role will become more and more relevant. Further studies with long-term follow-up are needed to determine the best form of treatment of these complex injuries. (Cite this article as: Tarallo L, Negri A, Novi M, Micheloni G, Keeling E, Porcellini G. Radial head fractures: review of current evidence about assessment, classification and management.