Bindal S, Pooni HS, Garg R, Jain D. Functional outcomes of radial head arthroplasty in Mason type III and IV fractures. World J Orthop 2025; 16(6): 106871 [DOI: 10.5312/wjo.v16.i6.106871]
Corresponding Author of This Article
Shikhar Bindal, MBBS, MS, Department of Orthopedics, Dayanand Medical College and Hospital, Civil Lines, Tagore Nagar, Ludhiana 141001, Punjab, India. shikharbindal@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shikhar Bindal, Harshaan Singh Pooni, Rajnish Garg, Deepak Jain, Department of Orthopedics, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Co-corresponding authors: Shikhar Bindal and Rajnish Garg.
Author contributions: Bindal S wrote the manuscript; Bindal S and Pooni HS acquired and analysed data; Bindal S, Pooni HS, and Garg R interpreted the data; Bindal S, Pooni HS, Garg R, Jain D designed and coordinated the study; all authors approved the final version of the article.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board at Dayanand Medical College and Hospital, Ludhiana, Punjab (Faculty of Medical Sciences, Dayanand Medical College and Hospital, No. BFUHS/2K23p-TH/62).
Informed consent statement: Ethical approval from the institutional ethics committee was obtained before initiating the study. Written informed consent was obtained from all study participants. Throughout the study, strict measures were taken to ensure privacy as well as confidentiality.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shikhar Bindal, MBBS, MS, Department of Orthopedics, Dayanand Medical College and Hospital, Civil Lines, Tagore Nagar, Ludhiana 141001, Punjab, India. shikharbindal@gmail.com
Received: March 10, 2025 Revised: April 8, 2025 Accepted: May 24, 2025 Published online: June 18, 2025 Processing time: 100 Days and 21 Hours
Abstract
BACKGROUND
Radial head fractures constitute approximately one-third of all elbow fractures, significantly impacting the young and active population. While open reduction and internal fixation is the preferred treatment for displaced fractures, its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty (RHA). RHA provides improved functional outcomes with fewer complications, yet its long-term efficacy remains a topic of debate.
AIM
To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.
METHODS
A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital, Ludhiana over 32 months (January 2021-August 2023). A total of 26 patients with Mason type III and IV fractures were included, with six retrospective and 20 prospective cases. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS), elbow range of motion, pain via Visual Analog Scale, and activities of daily living at immediate postoperative, three-month, and six-month follow-ups.
RESULTS
MEPS at 6 months follow up for 4 cases (15.38%) had good scores, and 22 cases (84.62%) had excellent scores, with a mean ± SD of 97.31 ± 6.67. Comparisons showed significant improvement from immediate post-operative to 3 months (P < 0.0001), from immediate post-operative to 6 months (P < 0.0001), and between 3 months and 6 months (P < 0.0001). None of the patients had elbow instability after radial head replacement and 22 cases (84.62%) had no complications, while 3 cases (11.54%) had a stiff elbow, and 1 case (3.85%) had heterotopic ossification.
CONCLUSION
RHA is an effective treatment for comminuted radial head fractures, providing stable elbow function with minimal complications.
Core Tip: Radial head arthroplasty is an effective treatment modality to restore the stability and congruency of elbows with comminuted radial head fractures (Mason type III and IV). In our study there was a significant improvement in the range of motion involving flexion, extension deficit, supination and pronation during the follow up period with minimal complications. There was also a significant improvement in the activities of daily living and Mayo Elbow Performance Score during follow ups at immediate post operative, 3 months and 6 months indicating improved quality of life after the surgery.
