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

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...

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Main Authors: Domenico De Mauro, MD, Sami Abou Chakra, Francesco Liuzza, MD, Amarildo Smakaj, MD, Giuseppe Rovere, MD, PhD, Giulio Maccauro, MD, Omar El Ezzo, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JSES International
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666638324003724
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author Domenico De Mauro, MD
Sami Abou Chakra
Francesco Liuzza, MD
Amarildo Smakaj, MD
Giuseppe Rovere, MD, PhD
Giulio Maccauro, MD
Omar El Ezzo, MD
author_facet Domenico De Mauro, MD
Sami Abou Chakra
Francesco Liuzza, MD
Amarildo Smakaj, MD
Giuseppe Rovere, MD, PhD
Giulio Maccauro, MD
Omar El Ezzo, MD
author_sort Domenico De Mauro, MD
collection DOAJ
description 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.
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spelling doaj-art-2f6ef37de1f54100a00a7f30d23973fc2025-01-12T05:25:56ZengElsevierJSES International2666-63832025-01-0191260267Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trialsDomenico De Mauro, MD0Sami Abou Chakra1Francesco Liuzza, MD2Amarildo Smakaj, MD3Giuseppe Rovere, MD, PhD4Giulio Maccauro, MD5Omar El Ezzo, MD6Orthopedic 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.Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, ItalyDepartment 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, ItalyDepartment of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Tor Vergata University, Rome, ItalyDepartment of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, Rome, Italy; Orthopedics and Traumatology Unit, Tor Vergata University, Rome, ItalyDepartment 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, ItalyDepartment 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, ItalyBackground: 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.http://www.sciencedirect.com/science/article/pii/S2666638324003724Radial head fracturesRadial head arthroplastyMason type-3Surgical treatmentsOpen reduction and internal fixationMeta-analysis
spellingShingle Domenico De Mauro, MD
Sami Abou Chakra
Francesco Liuzza, MD
Amarildo Smakaj, MD
Giuseppe Rovere, MD, PhD
Giulio Maccauro, MD
Omar El Ezzo, MD
Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
JSES International
Radial head fractures
Radial head arthroplasty
Mason type-3
Surgical treatments
Open reduction and internal fixation
Meta-analysis
title Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
title_full Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
title_fullStr Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
title_full_unstemmed Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
title_short Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials
title_sort radial head arthroplasty vs open reduction and internal fixation in mason 3 radial head fractures meta analysis of prospective trials
topic Radial head fractures
Radial head arthroplasty
Mason type-3
Surgical treatments
Open reduction and internal fixation
Meta-analysis
url http://www.sciencedirect.com/science/article/pii/S2666638324003724
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