Factors affecting outcome of partial radial head fractures: A Retrospective Cohort Study

Orthop Traumatol Surg Res. 2019 Dec;105(8):1585-1592. doi: 10.1016/j.otsr.2019.06.021. Epub 2019 Oct 31.


Background: The purpose of this study is to evaluate which factors will affect range of motion (ROM) and function in partial radial head fractures. The hypothesis is that conservative treatment yields better outcomes.

Materials and methods: This retrospective comparative cohort study included 43 adult volunteers with partial radial head fracture, a minimum 1-year follow up, separated into a surgical and non-surgical group. Risk factors were: associated injury, heterotopic ossification, worker's compensation, and proximal radio ulnar joint (PRUJ) implication. Outcomes included radiographic ROM measurement, demographic data, and quality of life questionnaires (PREE, Q-DASH, MEPS).

Results: Mean follow up was 3.5 years (1-7 years). Thirty patients (70%) had associated injuries with decreased elbow extension (-11°, p=0.004) and total ROM (-14°, p=0.002) compared to the other group. Heterotopic ossification was associated with decreased elbow flexion (-9.00°, p=0.001) and fractures involved the PRUJ in 88% of patients. Only worker's compensation was associated with worse scores. There was no difference in terms of function and outcome between patients treated non-surgically or surgically.

Discussion: We found that associated injuries, worker's compensation and the presence of heterotopic ossification were the only factors correlated with a worse prognosis in this cohort of patients. Given these results, the authors reiterate the importance of being vigilant to associated injuries.

Level of evidence: IV, Retrospective study.

Keywords: 3D CT-scan; PRUJ; ROM; Radial head fracture.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Conservative Treatment*
  • Elbow Injuries
  • Elbow Joint / physiopathology
  • Elbow Joint / surgery
  • Female
  • Follow-Up Studies
  • Fracture Fixation*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Radius Fractures / diagnosis
  • Radius Fractures / physiopathology
  • Radius Fractures / therapy*
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome