THE NONOPERATIVE MANAGEMENT OF RADIAL HEAD FRACTURES - A RANDOMIZED TRIAL OF 3 TREATMENTS

Ninety-eight consecutive patients with Mason type 1 and 2 radial head fractures were randomized into three treatment groups to compare early mobilization with immobilization in flexion and extension. Eighty-one patients were reviewed on average 25 months following fracture and as sessed for pain, disability and range of movement. Loss of full extens ion was the most frequent restriction of movement and was found in 1 7 patients. Two patients had restricted flexion without limited extensi on. Patients immobilized in a flexion cast had a significantly reduced range of movement compared with patients immobilized in extension (P = 0,02). Nineteen patients had residual pain and again the flexion gro up fared worse than the extension group (P = 0.06). Results from early mobilization in a sling were not significantly different from the oth er two groups. Treatment of radial head fractures in flexion casts sho uld be avoided.