Abstract

Fractures of the radial head are one of the most demanding injuries around the elbow, and it becomes a challenge when faced with a severely comminuted Mason Type III pattern. We encountered such a situation in a 33-year-old right-hand dominant woman who fell from a height and presented with pain, swelling, and restricted elbow motion. Imaging revealed a radial head shattered beyond the possibility of reconstruction. Recognising the limitations of fixation, we opted for radial head replacement using a monopolar press-fit prosthesis through the Kocher approach. Intraoperatively, care was taken to restore stability without overstuffing the joint, and early mobilisation was encouraged from the first postoperative day. At the three-month review, the patient had regained almost full pronation and supination, with an arc of flexion from 10° to 130° and a Mayo Elbow Performance Score of 95. Post-operative x-rays confirmed a well-placed implant without evidence of loosening. This report highlights that in young, active patients with irreparable radial head fractures, monopolar press-fit arthroplasty offers stability, enables early mobilisation, and can provide excellent functional recovery. Introduction: Comminuted radial head fractures, particularly Mason Type III, present significant challenges in achieving stable fixation. Radial head arthroplasty has emerged as a preferred option when reconstruction is not feasible, especially in young, active individuals. Case Report: We present the case of a 33-year-old right-handed female who sustained a Mason Type III radial head fracture following a fall from height. Due to severe comminution and articular disruption, open reduction and internal fixation was not possible. The patient underwent radial head replacement using a press-fit prosthesis via the Kocher approach. Early mobilisation was initiated on postoperative day five. At 12 weeks, the patient achieved a flexion-extension arc of 10°130° and near-complete forearm rotation, with a Mayo Elbow Performance Score of 95. Radiographs confirmed stable implant positioning without signs of loosening. Conclusion: Monopolar press-fit radial head arthroplasty is a reliable and effective solution for managing irreparable radial head fractures, promoting early rehabilitation and excellent functional outcomes in young patients.

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