Long-Term survival of Acumed Anatomical Radial Head implant for Mason Type III-IV fractures: a 15-year follow-up.

Introduction: Radial head fractures account for 1.7% to 5.4% of all skeletal fractures and approximately one-third of elbow fractures. These injuries are often associated with other concurrent injuries, such as fractures of the coronoid, ligamentous injuries of the elbow, or trauma to other regions of the upper limb. Intra-articular fractures, especially Mason type III and IV, often require anatomical reduction to restore the articular surface, but such procedures can yield suboptimal results, highlighting the role of radial head implants in complex cases.

Materials and methods: This retrospective study evaluated patients treated with Acumed Anatomical Radial Head implant from 2008 to 2023, specifically those with Mason type III and IV fractures. A total of 149 patients were included, with an average follow-up of 7 years.

Discussion: Clinical outcomes, assessed using the Mayo Elbow Performance Score (MEPS), showed an average score of 90, with an average range of motion of 130° in flexion and 78° in pronation and supination. Implant survival at 15 years exceeded 95%, confirming the long-term effectiveness of anatomical radial head implants. The most common complications included: heterotopic ossification with reduced joint mobility (35%), postoperative stiffness with functional limitations (9.4%), and implant loosening (4.7%).

Conclusions: Radial head implants offer a reliable treatment for complex Mason type III and IV fractures, with good functional and survival outcomes and a low incidence of complications. However, careful implant sizing is crucial to avoid complications such as premature loosening, joint stiffness and pain.