The surgical treatment of fractures of the radial head: a comparison between osteosynthesis and capitellectomy

Until the mid-eighties, capitellectomy was the treatment of choice for displaced fractures of the radial capitellum. The observation of complications such as instability of the elbow, proximal migration of the radius, valgus and humerus-ulna arthrosis, led us to safeguard the capitellum until the biomechanics of the elbow had been restored. A total of 20 patients treated surgically for Mason type II and III displaced fracture of the radial capitellum were studied retrospectively. The patients were divided into two homogeneous groups, of which group 1 was made up of patients treated by capitellectomy, and group 2 by those treated by osteosynthesis. The patients were seen again at mean follow-up of 44.6 months and submitted to clinical and radiographic evaluation. The clinical results were satisfactory in 80% of cases in group 1 and in 100% of cases in group 2. Radiographic signs of arthrosis were present in 90% of patients who had undergone capitellectomy, and in 20% of those who had undergone osteosynthesis.