Radial head fractures and their effect on the distal radioulnar joint. A rationale for treatment.

Nineteen patients were treated with open reduction and internal fixation for radial head fractures. Open reduction and internal fixation was performed to avoid radial head excision and the possible development of distal radioulnar joint dysfunction. Follow-up observation, which averaged 11.7 months, revealed that no patient developed wrist pain. Range of motion of the elbow and forearm was found to be complete in 14 patients and minimally restricted in four. Fourteen patients were pain free with full activity, and four had mild to moderate pain after heavy labor. One patient subsequently required radial head excision. Based on these findings and the authors continued disappointment with treatment of distal radioulnar joint dysfunction caused by proximal radial migration after radial head excision, the authors recommend early open reduction and internal fixation of all displaced or angulated radial head fractures.