Open Reduction and Internal Fixation with Headless Screws for Radial Head Fractures - A Good Choice with Good Clinical Outcomes: Case Series

Background:
Radial head fractures are the commonest fractures in the elbow. They are often associated with other injuries: ligamentous, cartilaginous or other fractures. Associated injuries are important determinant of the management of the radial head fracture. These should be carefully looked for, diagnosed and treated. Radial head fractures can be treated either conservatively or operatively (by excision, open reduction and internal fixation or prosthetic replacement). Internal fixation by headless cannulated screws is the preferred treatment for displaced fractures although controversial for 3 parts or wors. It provides satisfactory biomechanical stability, can be done through a smaller incision, has less complications and lesser requirement of later removal of screws. Screw fixation has the advantage of less periosteal stripping and less impingement compared to other fixation methods and also allows for flexible fixation in constrained areas. Transverse radial neck involvement or axial instability with screw-only fixation has historically required the additional use of a mini fragment T-plate or locking proximal radius plate. More recently, less invasive techniques such as the cross-screw and tripod techniques have been proposed. We want to present our experience with open reduction and internal fixation (ORIF) using headless screws (HS) for radial head fractures.

Methods:
Between the years 2019- 2021 we treated 270 patients who were diagnosed with radial head fractures. Among those 15 patients (6 females), with ORIF using HS. Patients ages were 16- 58, all had radial head fracture classifide as mason II- III.

Results:
All were with generally good reults, no significant disabillity and minimal range of motion limitation. No revision surgeries were needed.

Conclusion:
Open reduction and internal fixation with HS is a good treatment option when operated in the right indications.