Purpose:To evaluate the functional and radiological outcome of comminuted radial head fractures,which were not amenable for classical open reduction with intal fixation,treated by on-table reconstruction and fixation using low profile plates.Methods:We reviewed 6 patients of Mason type Ⅲ radial head fractures treated by on-table reconstruction technique between 2011 and 2013,There were 5 men and 1 woman with a mean age of 35 years (range 25-46 years).All surgeries were carried out at our tertiary care level 1 trauma centre within a mean of 3 days (range 1-8 days) from date of injury using on-table reconstruction technique.The functional outcome was measured using elbow functional rating index described by Broberg and Morrey and the patient-based Disabilities of the Arm,Shoulder and Hand (DASH) outcome measure.Results:The mean follow-up period was 25 months.The average elbow flexion was 135° (range 125° -140°) and the average flexion contracture was 5° (range 0-10°).The average supination and pronation was 75° (range 70°-80°) and 70° (range 65°-82°) respectively.According to Broberg and Morrey scoring system,the average score was 90 points (range 75-100).The mean DASH score was 2.49 points.Conclusion:On-table reconstruction and fixation of comminuted radial head fractures using low profile plates is a reasonable option.The reconstructed radial head acts as spacer and provides reasonably good results and no surgical intervention is required for asymptomatic nonunion of these fractures regardless of the radiological findings.