Objective To investigate and analyze whether the different types of radial head fracture and internal fixations have influence on the out comeof elbow function after surgery. Methods We reviewed the clinical data of 46 cases of radial head fractures from August 2002 to December 2008, 34 males, and 12 females, aged from 19 to 51years. All these cases underwent open reduction and internal fixation including fixation with Kirschner wire fixation, mini-plate and/or screw fixation and radial head resection. Results Forty-six cases were followed up in this study for a period of 8 months to 4 years (mean 2 yeats and 4 months).According to Mayo assessment of elbow function, the results of 35 cases were excellent or good (35/46 cases, 76.1%). Better function recovery was got in those who were preferred mini-screw internal fixation or combined with mini-plate. The same results were also found in those with Mason type Ⅱ fracture and in those underwent surgery within 2 weeks. Conclusions Good results can be got through surgical treatment as the indication of open reduction is clear, especially in cases with radial head fracture of Mason type Ⅱ and Ⅲ.The type of radial head fracture, the method of internal fixation and the timing of surgery all affect the outcome.