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Purpose <p>Radial head fractures (RHF) plate fixation has been associated with chronic pain and stiffness. This study aimed to evaluate if the new generation of anatomic low-profile locking-plates (ALPLP) allows to obtain satisfactory results lowering the complication rate and the need for reintervention.</p> Methods <p>Fifty-seven patients treated with ALPLP for RHF were analyzed: 24 were Mason II fractures and 33 were Mason III fractures. Post-operative and follow-up radiographs, range of motion and clinical scores (MEPS, DASH and ASES-e) were evaluated. Complications and reinterventions were recorded. The statistical analysis was performed using the ANOVA with post-hoc Tukey and Chi-squared test.</p> Results <p>The mean follow-up was 5 years. The mean ROM was 9°-140° in extension-flexion and 81°-81° in pronation-supination; the mean MEPS, DASH and ASES-E were 98, 3 and 93.9, respectively. Eight patients underwent reinterventions during follow-up, two patients developed asymptomatic nonunions. Significant differences were observed between Mason II and Mason III patients as for flexion and between patients who underwent “<i>in situ</i>” or “on table” reconstruction in terms of MEPS. Degenerative changes appeared to be significantly more frequent in RHF with involvement of the articular surface with respect to isolated neck RHF.</p> Conclusion <p>The main indications for osteosynthesis with ALPLP were a Mason II fracture with sinking of the head-neck junction and a multifragmentary Mason III fracture without radial neck comminution; with these indications, ALPLP provide satisfactory results in most cases, allowing to preserve the radial head in 96.5% of cases. The anatomical reduction of fracture, the sub-equatorial positioning of the plate in the “safe zone”, the reconstruction of the annular ligament without excessive tension and the early rehabilitation are the four main factors that affect results.</p>

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Mid-term clinical results of anatomic low-profile locking plates in the treatment of radial head fractures: a consecutive series of 57 patients

  • 期刊论文

  • 发表日期：

    2026年1月13日

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  • Giuseppe Giannicola,
  • Beatrice Caressa,
  • Sebastien Prigent,
  • Andrea Amura,
  • Pasquale Sessa

摘要

Purpose

Radial head fractures (RHF) plate fixation has been associated with chronic pain and stiffness. This study aimed to evaluate if the new generation of anatomic low-profile locking-plates (ALPLP) allows to obtain satisfactory results lowering the complication rate and the need for reintervention.

Methods

Fifty-seven patients treated with ALPLP for RHF were analyzed: 24 were Mason II fractures and 33 were Mason III fractures. Post-operative and follow-up radiographs, range of motion and clinical scores (MEPS, DASH and ASES-e) were evaluated. Complications and reinterventions were recorded. The statistical analysis was performed using the ANOVA with post-hoc Tukey and Chi-squared test.

Results

The mean follow-up was 5 years. The mean ROM was 9°-140° in extension-flexion and 81°-81° in pronation-supination; the mean MEPS, DASH and ASES-E were 98, 3 and 93.9, respectively. Eight patients underwent reinterventions during follow-up, two patients developed asymptomatic nonunions. Significant differences were observed between Mason II and Mason III patients as for flexion and between patients who underwent “in situ” or “on table” reconstruction in terms of MEPS. Degenerative changes appeared to be significantly more frequent in RHF with involvement of the articular surface with respect to isolated neck RHF.

Conclusion

The main indications for osteosynthesis with ALPLP were a Mason II fracture with sinking of the head-neck junction and a multifragmentary Mason III fracture without radial neck comminution; with these indications, ALPLP provide satisfactory results in most cases, allowing to preserve the radial head in 96.5% of cases. The anatomical reduction of fracture, the sub-equatorial positioning of the plate in the “safe zone”, the reconstruction of the annular ligament without excessive tension and the early rehabilitation are the four main factors that affect results.