Open Reduction And Internal Fixation Vs Conservative Treatment Of Mason Ⅱ Radial Head Fracture:A Meta-analysis

Aims: To conduct a meta-analysis of the outcomes of surgical and non-surgical treatment of Mason Ⅱ radial tuberosity fractures.Methods: Two researchers independently searched Pub Med/Medline,the Dutch Medical Abstracts Database(Embase),Thomson Scientific Information Group’s Web of Science,Cochrane Library,Wanfang Database,and China Knowledge Network(CNKI).The literature published in each database up to September 2022 was screened according to inclusion and exclusion criteria,and the Cochrane guidelines were followed for quality assessment and data extraction.Results: A total of 6 retrospective studies and 2 RCTs were included,and clinical data from 410 patients(209 in the surgical group and 201 in the non-surgical group)were obtained for Meta-analysis.The surgical group had better elbow function compared to the control group,as rated by Morrey and Broberg(OR=5.40,95%CI2.47,11.81,p<0.01),better outcomes in terms of pain relief,return to work,postoperative pain(OR=0.45,95%CI 0.23,0.88,p=0.02),decreased muscle strength(OR =0.48 95%CI 0.24,0.97 p=0.04).The difference in overall complication rates(complications such as postoperative pain,decreased muscle strength,osteonecrosis,radial head necrosis,heterotopic ossification,delayed ulnar neuritis and reflex sympathetic atrophy)between the two groups was not statistically significant(OR=0.43 95%CI 0.16,1.10 p>0.05).Conclusions: In patients with Mason Ⅱ radial tuberosity fractures,the surgical group did not reduce overall complications,but surgical treatment had a significant advantage in reducing the risk of postoperative pain and restoring muscle strength,and was significantly better than the conservative group for long-term evaluation of elbow function on the Morrey and Broberg scale.