Early controlled mobilisation improves functional outcomes in nonoperatively treated radial head fractures: A multicenter retrospective cohort study

Abstract

Design

Retrospective multicentre cohort study.

Setting

Data were collected between 2015 and 2024 from the orthopaedic departments of multiple hospitals.

Participants

Adult patients with isolated Mason type I and selected Mason type II radial head fractures (≤2 mm displacement, no mechanical block) treated nonoperatively between 2015 and 2024 were included. A total of 174 patients met the inclusion criteria and completed a minimum follow-up of 24 months.

Intervention

Patients were allocated to either early controlled mobilisation using a functional brace (Group 1) or delayed rehabilitation following four weeks of long-arm cast immobilisation (Group 2).

Main measures

Primary outcome measures were the Mayo Elbow Performance Score at final follow-up. Secondary outcomes included elbow range of motion, pain assessed using the visual analogue scale, time to return to work, and treatment-related complications.

Results

Early controlled mobilisation was associated with slightly higher functional outcome scores, including the Mayo Elbow Performance Score (89.5 vs 87.0) and the Oxford Elbow Score (87.3 vs 85.0). Differences were also observed in elbow flexion (138.0° vs 134.8°), pain scores (0.67 vs 1.01), and time to return to work (10.5 vs 11.7 weeks), whereas extension loss and forearm rotation were comparable between groups. Complication rates were similar. However, the magnitude of these differences did not exceed established minimal clinically important difference thresholds.

Conclusions

Early controlled mobilisation is a safe and reasonable approach in the nonoperative management of radial head fractures. Although small differences favouring early mobilisation were observed, no clinically meaningful difference was identified between the two approaches.

Keywords

Radial head fractures rehabilitation early mobilisation nonoperative treatment elbow joint

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