Radial head fractures treated by open reduction and internal fixation with an extensor digitorum communis split approach

Background
The treatment of displaced fractures of the radial head is controversial, with conflicting evidence to support either resection or open reduction and internal fixation. The aim of the present study was to evaluate the outcomes of primary open reduction and internal fixation of displaced radial head fractures using the extensor digitorum communis (EDC) split approach.
Patients and methods
Between June 2007 and September 2011, 19 consecutive patients with a displaced radial head fracture underwent open reduction and internal fixation. All fractures were classified as type III according to the Mason classification system. The EDC split approach was used. The Mayo Elbow Performance Score was used for clinical assessment.
Results
The Mayo Elbow Performance Score averaged 81.4 points postoperatively. According to this scoring system, the result was rated as excellent for 13 patients, good for three patients, and fair for three patients. There was a slight radiographic degenerative change only in two elbows.
Conclusion
Following a displaced radial head fracture, the overall results of radial head preservation by open reduction and internal fixation would be better in terms of satisfactory joint motion, with greater strength and better function. The EDC split approach provides good access to the displaced fragments.