{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:43:28Z","timestamp":1789649008935,"version":"4.0.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n To compare the results of radial head arthroplasty (RHA) and open reduction internal fixation (ORIF) for radial head fracture treatment based on patient age.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Two academic Level 1 Trauma centers.<\/jats:p>\n <\/jats:sec>\n \n Patient Selection Criteria:<\/jats:title>\n Included were patients treated with RHA or ORIF for a radial head fracture (Orthopaedic Trauma Association classification 2R1A\/B\/C) between January 2015 and September 2022.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Postoperative surgical outcomes, including reoperations, final elbow range of motion, and radiographic features, were collected. The outcomes of RHA and ORIF in patients above and below 40 years were compared using bivariate and multivariable regression analyses.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n The study cohort included 161 operative radial head fractures sustained in 160 patients of which 47% were male (n = 75). Thirty-two patients were included in the RHA <40-year group [mean age 31 years, SD 5; 72% were male (n = 23)], 96 patients in the RHA \u226540-year group [mean age 60 years, SD 11; 34% were male (n = 33)], and 22 patients in the ORIF <40-year group [mean age 27 years, SD 6; 64% were male (n = 14)]. In patients <40 years old, RHA versus ORIF had comparable flexion\u2013extension (125 degrees vs. 128 degrees,\n P<\/jats:italic>\n = 0.79) prono-supination (145 degrees vs. 140 degrees,\n P<\/jats:italic>\n = 0.16), and reoperation rate (22% vs. 14%,\n P<\/jats:italic>\n = 0.50). Rates of post-traumatic arthritis were higher for RHA versus ORIF in this age group (57% vs. 27%,\n P<\/jats:italic>\n = 0.047), although the follow-up period for radiographic assessment in the RHA <40-year group was slightly longer than the ORIF <40-year group (12.7 \u00b1 10.4 months vs. 7.6 \u00b1 4.6 months,\n P<\/jats:italic>\n = 0.04). When comparing patients \u226540 years old with those <40 years old, outcomes of RHA had comparable flexion\u2013extension (125 degrees vs. 125 degrees,\n P<\/jats:italic>\n = 0.93) prono-supination (145 degrees vs. 150 degrees,\n P<\/jats:italic>\n = 0.07), reoperation rate (22% vs. 15%,\n P<\/jats:italic>\n = 041), and post-traumatic arthritis rate (57% vs. 64%,\n P<\/jats:italic>\n = 0.34). Younger patients exhibited a lower frequency and severity of stem radiolucency than older patients (53% vs. 67%,\n P<\/jats:italic>\n = 0.01).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n For patients under 40 years, ORIF and RHA yielded comparable outcomes. RHA had a higher risk of post-traumatic arthritis, favoring ORIF for younger patients if technically feasible. Older patients should be aware of the increased risk of stem lucency when undergoing RHA.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003083","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T13:00:27Z","timestamp":1758632427000},"page":"e73-e81","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Comparing Radial Head Fracture Surgical Outcomes in Patients Younger and Older Than Forty"],"prefix":"10.1097","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7642-8926","authenticated-orcid":false,"given":"Kevin","family":"Kooi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Boston, MA;"},{"name":"Harvard Medical School, Boston, MA;"},{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam UMC, Amsterdam, the Netherlands;"},{"name":"Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stam","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Boston, MA;"},{"name":"Harvard Medical School, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingmar","family":"Legerstee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Boston, MA;"},{"name":"Harvard Medical School, Boston, MA;"},{"name":"Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam, the Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cedars-Sinai Medical Center in Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-8732","authenticated-orcid":false,"given":"Wen-Chih","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Boston, MA;"},{"name":"Harvard Medical School, Boston, MA;"},{"name":"Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; and"},{"name":"School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9170-4745","authenticated-orcid":false,"given":"Abhiram R.","family":"Bhashyam","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Boston, MA;"},{"name":"Harvard Medical School, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260213","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11751-008-0038-8","article-title":"The incidence of associated fractures of the upper limb in fractures of the radial head","volume":"3","author":"Kaas","year":"2008","journal-title":"Strateg Trauma Limb Reconstr"},{"key":"R2-20260213","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.jhsa.2008.12.024","article-title":"Radial head fractures\u2013an update","volume":"34","author":"Pike","year":"2009","journal-title":"J Hand Surg Am"},{"key":"R3-20260213","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.hcl.2017.09.008","article-title":"Elbow fractures with instability: evaluation and treatment strategies","volume":"34","author":"Chen","year":"2018","journal-title":"Hand Clin"},{"key":"R4-20260213","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s00402-017-2693-z","article-title":"Using an anatomically preshaped low-profile locking plate system leads to reliable results in comminuted radial head fractures","volume":"137","author":"Cr\u00f6nlein","year":"2017","journal-title":"Arch Orthop Trauma Surg"},{"key":"R5-20260213","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.hcl.2015.06.003","article-title":"Fractures of the radial head","volume":"31","author":"Burkhart","year":"2015","journal-title":"Hand Clin"},{"key":"R6-20260213","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/BOT.0b013e31812e5168","article-title":"Low profile fixation of radial head and neck fractures: surgical technique and clinical experience","volume":"21","author":"Smith","year":"2007","journal-title":"J Orthop Trauma"},{"key":"R7-20260213","doi-asserted-by":"crossref","first-page":"660.e1","DOI":"10.1016\/j.jhsa.2017.04.005","article-title":"Radial head arthroplasty in the active duty military service member with minimum 2-year follow-up","volume":"42","author":"Dunn","year":"2017","journal-title":"J Hand Surg Am"},{"issue":"suppl 2","key":"R8-20260213","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/s43465-020-00136-0","article-title":"Radial head arthroplasty, excision and osteosynthesis in complex elbow fracture\u2013dislocations in young adults: what is preferred?","volume":"54","author":"Sinha","year":"2020","journal-title":"Indian J Orthop"},{"key":"R9-20260213","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.jhsa.2021.06.011","article-title":"The unsalvageable radial head in patients aged 30 years and younger","volume":"46","author":"Sims","year":"2021","journal-title":"J Hand Surg Am"},{"key":"R10-20260213","doi-asserted-by":"crossref","first-page":"1059.e1","DOI":"10.1016\/j.jhsa.2022.02.020","article-title":"Open reduction internal fixation of simple versus comminuted radial head fractures: comparison of clinical outcomes","volume":"48","author":"Walsh","year":"2023","journal-title":"J Hand Surg Am"},{"key":"R11-20260213","first-page":"1363","article-title":"Advanced trauma life support (ATLS\u00ae): the ninth edition","volume":"74","author":"ATLS Subcommittee","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"key":"R12-20260213","first-page":"51","article-title":"A follow up of one hundred cases of fracture of the head of the radius with a review of the literature","volume":"31","author":"Johnston","year":"1962","journal-title":"Ulster Med J"},{"key":"R13-20260213","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0749-0712(21)01180-X","article-title":"The classification and treatment of heterotopic ossification about the elbow and forearm","volume":"10","author":"Hastings","year":"1994","journal-title":"Hand Clin"},{"key":"R14-20260213","doi-asserted-by":"crossref","first-page":"669","DOI":"10.2106\/00004623-198668050-00005","article-title":"Results of delayed excision of the radial head after fracture","volume":"68","author":"Broberg","year":"1986","journal-title":"J Bone Joint Surg Am"},{"key":"R15-20260213","first-page":"2192","article-title":"Comminuted radial head fractures treated with a modular metallic radial head arthroplasty: study of outcomes","volume":"88","author":"Grewal","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"R16-20260213","doi-asserted-by":"crossref","first-page":"2676","DOI":"10.1002\/sim.4509","article-title":"Classification accuracy and cut point selection","volume":"31","author":"Liu","year":"2012","journal-title":"Stat Med"},{"key":"R17-20260213","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1007\/s00264-017-3496-0","article-title":"Causes for early and late surgical re-intervention after radial head arthroplasty","volume":"41","author":"Laumonerie","year":"2017","journal-title":"Int Orthop"},{"key":"R18-20260213","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.jse.2010.05.022","article-title":"Mid- to long-term results after bipolar radial head arthroplasty","volume":"19","author":"Burkhart","year":"2010","journal-title":"J Shoulder Elbow Surg"},{"key":"R19-20260213","doi-asserted-by":"crossref","first-page":"e815","DOI":"10.3928\/01477447-20120525-18","article-title":"Incidence and risk factors of heterotopic ossification following major elbow trauma","volume":"35","author":"Douglas","year":"2012","journal-title":"Orthopedics"},{"key":"R20-20260213","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jse.2014.11.037","article-title":"Heterotopic ossification formation after fracture-dislocations of the elbow","volume":"24","author":"Shukla","year":"2015","journal-title":"J Shoulder Elbow Surg"},{"key":"R21-20260213","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2106\/00004623-198163060-00002","article-title":"A biomechanical study of normal functional elbow motion","volume":"63","author":"Morrey","year":"1981","journal-title":"J Bone Joint Surg Am"},{"key":"R22-20260213","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1016\/j.jse.2021.03.142","article-title":"Long-term outcomes of radial head arthroplasty for radial head fractures\u2014a systematic review at minimum 8-year follow-up","volume":"30","author":"Davey","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"R23-20260213","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.2106\/00004623-200210000-00011","article-title":"Open reduction and internal fixation of fractures of the radial head","volume":"84","author":"Ring","year":"2002","journal-title":"J Bone Joint Surg Am"},{"key":"R24-20260213","doi-asserted-by":"crossref","first-page":"102814","DOI":"10.1016\/j.otsr.2021.102814","article-title":"Post-traumatic elbow osteoarthritis after radial head arthroplasty: prevalence and risk factors","volume":"107","author":"Antoni","year":"2021","journal-title":"Orthop Traumatol Surg Res"},{"key":"R25-20260213","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1007\/s11999-013-3331-x","article-title":"Fixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis?","volume":"472","author":"Watters","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"R26-20260213","doi-asserted-by":"crossref","first-page":"e20201","DOI":"10.5812\/traumamon.20201","article-title":"Outcome of radial head arthroplasty in comminuted radial head fractures: short and midterm results","volume":"21","author":"Moghaddam","year":"2016","journal-title":"Trauma Mon"},{"key":"R27-20260213","first-page":"375","article-title":"Evaluation of radiocapitellar arthritis in patients with a second radiograph at least 2 years after nonoperative treatment of an isolated radial head fracture","volume":"5","author":"Kachooei","year":"2017","journal-title":"Arch Bone Joint Surg"},{"key":"R28-20260213","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/00005373-200101000-00009","article-title":"The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review","volume":"50","author":"Harrington","year":"2001","journal-title":"J Trauma"},{"key":"R29-20260213","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/j.jse.2019.03.014","article-title":"Low return-to-sports rate after elbow injury and treatment with radial head arthroplasty","volume":"28","author":"Jung","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"key":"R30-20260213","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1007\/s00590-021-03129-3","article-title":"Cemented radial head arthroplasty: does radiographic loosening have an effect on clinical and functional outcomes? Average 10 years' results","volume":"32","author":"Pehlivanoglu","year":"2022","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"R31-20260213","doi-asserted-by":"crossref","first-page":"1041531","DOI":"10.3389\/fbioe.2022.1041531","article-title":"A systematic review and meta-analysis on different stem fixation methods of radial head prostheses during long-term follow-up","volume":"10","author":"Yang","year":"2022","journal-title":"Front Bioeng Biotechnol"},{"key":"R32-20260213","first-page":"105","article-title":"The epidemiology of osteoporosis","volume":"133","author":"Clynes","year":"2020","journal-title":"Br Med Bull"},{"key":"R33-20260213","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s12891-023-06218-y","article-title":"Clinic follow-up of orthopaedic trauma patients during and after the post-surgical global period: a retrospective cohort study","volume":"24","author":"Bhashyam","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"R34-20260213","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1302\/0301-620X.99B12.BJJ-2017-0543.R2","article-title":"The minimum follow-up required for radial head arthroplasty: a meta-analysis","volume":"99","author":"Laumonerie","year":"2017","journal-title":"Bone Joint J"}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000003083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:08:24Z","timestamp":1770991704000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000003083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000003083","relation":{},"ISSN":["0890-5339","1531-2291"],"issn-type":[{"value":"0890-5339","type":"print"},{"value":"1531-2291","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-09-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}