Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement

Abstract

Background Fixation of radial head fractures with neck involvement presents challenges. It remains unclear whether the outcomes of head-to-neck screw fixation are similar to those of arthroplasty in this scenario. We conducted a retrospective cohort study to evaluate the clinical outcomes of these two methods for treating such fractures. Methods Demographic data, fracture type, number of fragments, and concomitant injuries were recorded. Range of motion, Visual Analogue Scale for pain, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand at three-year follow-up, complications, and reintervention were compared. Results A total of 14 patients underwent fixation with head-to-neck screws, and 15 an arthroplasty. Baseline characteristics between groups were similar ( P > .05). Satisfactory range of motion (arc > 100°) was achieved in nine patients (64%) in the fixation group, and eight patients (53%) in the arthroplasty group ( P = .55). The mean Visual Analogue Scale, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand were 1.2 ± 1.2, 91.7 ± 10.7, and 9.1 ± 1, respectively, ( P = .651, P = .651, and P = .155). Three patients (21%) in the fixation group underwent a reintervention and three (20%) in the arthroplasty group ( P = .639). Discussion Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement.