Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials

Domenico De Mauro, MD; Sami Abou Chakra; Francesco Liuzza, MD; Amarildo Smakaj, MD; Giuseppe Rovere, MD, PhD; Giulio Maccauro, MD; Omar El Ezzo, MD

JSES International (Jan 2025)

Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials

Domenico De Mauro, MD,
Sami Abou Chakra,
Francesco Liuzza, MD,
Amarildo Smakaj, MD,
Giuseppe Rovere, MD, PhD,
Giulio Maccauro, MD,
Omar El Ezzo, MD

Affiliations

Domenico De Mauro, MD: Orthopedic Unit, Department of Public Health, Federico II University, Naples, Italy; Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Department of Ageing, Orthopedics and Rheumatological Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Corresponding author: Domenico De Mauro, MD, Orthopedic Unit, Department of Public Health, Federico II University, Via Sergio Pansini, 5, Naples 80131, Italy.
Sami Abou Chakra: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy
Francesco Liuzza, MD: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Department of Ageing, Orthopedics and Rheumatological Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Amarildo Smakaj, MD: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Tor Vergata University, Rome, Italy
Giuseppe Rovere, MD, PhD: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Tor Vergata University, Rome, Italy
Giulio Maccauro, MD: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Department of Ageing, Orthopedics and Rheumatological Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Omar El Ezzo, MD: Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Department of Ageing, Orthopedics and Rheumatological Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Journal volume & issue: Vol. 9, no. 1
pp. 260 – 267

Abstract

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Background: Radial head fractures (RHF) represent about one-third of all elbow fractures, comprising approximately 2%-5% of all fractures sustained. The aims of this systematic review and meta-analysis are as follows: (i) to compare complications rate in patients undergoing radial head arthroplasty (RHA) or open reduction and internal fixation as surgical treatments for Mason type 3 RHF; (ii) to compare clinical outcome and functional score in patients undergoing RHA or ORIF in Mason type 3 RHF. Methods: Following the preferred reporting items for systematic reviews and meta-analyses guidelines, a comprehensive literature systematic review of literature was conducted up to March 2024. All prospective studies were included. The analysis employed the log odds ratio (OR) and 95% confidence interval (CI) as the outcome measure. Results: Six studies were incorporated into the systematic review. A total of three studies, published between 2009 and 2021, were included in the meta-analysis. A cohort of 169 patients affected by Mason 3 RHFs was collected. The ORIF group included 65 patients, and 26 events of complications after ORIF were observed. RHA group, instead, consisted of 70 patients, and 8 events of complications were identified. Conclusion: Our findings reveal that the Mason type 3 RHFs treated with open reduction and internal fixation, exhibits a higher risk of complications compared to those patients treated with RHA. Moreover, the standardized mean difference analysis suggests that the ORIF group demonstrates a lower mean Broberg and Morrey Elbow score in comparison to the RHA group, with a higher functional recovery in RHA group.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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Abstract

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