IMMEDIATE MOBILIZATION FOR MASON TYPE II RADIAL HEAD FRACTURES: A CONE-BEAM CT STUDY

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Andrea Poggetti, Andrea Del Chiaro, Anna Maria Nucci, Salvatore Massimo Stella, Marco Cecchini, Prospero Bigazzi, Irene Felici, Giovanni Munz, Antonio D’Arienzo, Sandra Pfanner

The management of Mason type II radial head fractures is still debated. Retrospective comparative studies suggest that long-term clinical results of both operative and non-operative treatments are very good. The proper mobilization protocol is one of the most critical point of discussion. Our study aim is to establish effects of an immediate active elbow mobilization (I-RAM) on cadaveric models of radial head fractures. We performed Mason II radial head fractures on 5 frozen intact human upper limbs. We than analyzed the effects of I-RAM on cadaveric models using Cone-Beam Computerized- Tomography (CBCT). A statistically significant reduction in fragments diastasis after fracture reduction and after 0-30° range of motion was found. The 30-110° motion range was not able to increase fragments diastasis too. Our study shows that an extremely early mobilization after a Mason II radial head fracture does not significantly increase fragments displacement. Principal limitations of this study are due to the use of a cadaveric model, mainly the absence the hematoma and swelling development and fracture-associated soft-tissue injuries. For this reason, we are planning a perspectival study to test results of early mobilization (I-RAM) also on living models.

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