Nonunion of the radial neck following operative treatment for displaced radial head and neck fractures

Nonunion of the radial neck is uncommon after operative treatment of displaced radial head and neck fractures. Treatment of nonunion of the radial neck remains a subject of debate and various treatment options have been introduced. This study presents six patients with nonunion of the radial neck following operative treatment for displaced radial head and neck fractures and the long-term clinical outcomes of conservative treatment for nonunion of the radial neck. Three hundred and twenty-six patients underwent operative treatment for displaced fractures of the radial head and neck from 1996 to 2008; six of these patients (1.8%) developed nonunion of the radial neck. No additional surgical treatment was undertaken after nonunion was confirmed. Time from primary operation to diagnosis of nonunion, clinical presentation, radial head-shaft angle, range of motion and residual angulations on plain radiographs were documented. Functional outcomes were evaluated using the Mayo elbow performance index (MEPI) at final follow-up visit. Average time from primary operation to diagnosis of nonunion was 10.2 months. Five patients reported no functional deficits and no clinical discomfort when nonunions were confirmed. Another patient complained of mild elbow discomfort only when lifting heavy weights. All patients achieved satisfactory clinical outcomes after an average follow-up of 7.6 years. Regardless of radiological findings, no further surgical treatment is recommended for asymptomatic nonunion of the neck of the radius.