Twenty-one patients had a delayed excision of a previously fractured
radial head (range, one month to more than twenty years). There were four
Mason type-II and seventeen Mason type-III fractures. Five fractures had
been associated with a concomitant dislocation of the elbow and four, with
an ulnar fracture. All of the patients were evaluated for pain, motion,
strength, stability, and function by personal interview, examination, and
testing in an upper-extremity-biomechanics laboratory. The average length
of follow-up was fifteen years (range, three to thirty-two years).
Postoperatively, pain was less severe in 76 per cent of the patients and
motion was improved in both flexion and rotation in 81 per cent. An
objective functional index showed that 77 per cent of the patients had a
good or excellent result while 23 per cent had a fair or poor result. This
study demonstrates the effectiveness of delayed excision after failure of
closed management of fractures of the radial head. Thus, some justification
is offered for the initial closed treatment of these fractures, with
delayed excision of the radial head to be considered as needed.