Contribution of Monoblock and Bipolar Radial Head Prostheses to Valgus Stability of the Elbow

Pomianowski, Stanisław; Morrey, B.F.; Neale, Patricia G.; Park, Min J.; O’Driscoll, Shawn W.; An, Kai Nan

doi:10.2106/00004623-200112000-00010

Cited by 175 publications

(93 citation statements)

References 17 publications

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“…In cadaver studies, both types of prosthesis provide equal stability in MCL-deficient elbows, but not to the same degree as the native radial head (Pomianowski et al 2001). The titanium monobloc prosthesis is nonanatomic in design; problems with sizing have been reported and the wear characteristics of titanium are not ideal (Ashwood et al 2004).…”

Section: Discussionmentioning

confidence: 98%

Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: Good outcome after 1–4 years follow-up in 11 patients

et al. 2005

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BackgroundIn the presence of additional disruption of the distal radioulnar ligaments, the interosseous membrane, or the lateral-and/or medial collateral ligament, radial head fractures treated by resection will result in valgus elbow instability, proximal radial migration and/or posterolateral rotatory instability. Radial head replacement has been used to treat or prevent this. We report our experience with the Judet CRF II radial head prosthesis.Patients and methods We treated 11 patients with a bipolar radial head prosthesis because of elbow instability after previous treatment for Mason-Johnston type III or IV radial head fractures. The outcome was assessed clinically using two standardized elbow function assessment scales, and radiographically after a mean followup of 2 years.Results Clinical outcome was either good or excellent in all patients; all elbows were stable. Radiographically, there were no signs of loosening, fracture or heterotopic ossification. 2 patients required reoperation for subluxation of the prosthesis; both were treated by reducing the size of the modular head of the prosthesis. There was erosion of the capitellum in 1 patient.Interpretation Bipolar radial head replacement can be used successfully for treatment of the sequelae of radial head fractures. The long-term outcome is, however, unknown.

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Section: Discussionmentioning

confidence: 98%

Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: Good outcome after 1–4 years follow-up in 11 patients

et al. 2005

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“…Close replication of the native radial head dimensions by the inserted prosthesis is required for the restoration of near-normal stability and kinematics of the affected elbow [6,8,13]. The insertion of an incorrectly sized prosthesis is associated with instability, maltracking, and early degeneration of the joint.…”

Section: Discussionmentioning

confidence: 99%

Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?

Moon

Hong

Bither

et al. 2013

Clin Orthop Relat Res

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Background Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and earlyonset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred. Questions/purposes We therefore hypothesized that overlengthening the radial head during radial head arthroplasty changes the ulnar variance in the wrist. Methods Seven cadaveric radii were implanted with radial head prostheses of increasing thickness. Each specimen was implanted successively with increasingly thick radial head prostheses measuring 2, 4, and 6 mm thicker than the native radial head, and radiographs were taken after implantation of each prosthesis. The ulnar variance with each prosthesis was measured using the method of perpendiculars.Results The ulnar variance of the native and 2-mm (p = 0.04), 4-mm (p = 0.008), and 6-mm (p = 0.008) overly thick radial head prosthesis-implanted states decreased significantly with each incremental increase in prosthetic head thickness. Conclusions Implantation of thicker radial head prostheses decreased the ulnar variance. Our results indicate ulnar variance could be used to detect overstuffing of radial head prostheses. Clinical Relevance The simplicity and reliability of ulnar variance make it a potentially useful indicator of overlengthening after radial head arthroplasty.

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“…Niekiedy wieloodłamowe złamania głowy kości promieniowej są niemożliwe do chirurgicznego zespolenia i stanowią wskazanie do endoprotezoplastyki głowy kości promieniowej lub, w niektórych przypadkach, usunięcia złamanej głowy [5]. Jeśli usunięcie głowy kości promieniowej, złamanie wyrostka dziobiastego lub uszkodzenie więzadła pobocznego przyśrodkowego po wodują niestabilność łokcia, to należy rozważyć endoprotezoplastykę głowy kości promieniowej [6]. Endoprotezoplastyka jest również wskazana w przypadkach wieloodłamowego złamania głowy i zwichnięcia stawu promieniowo-łokciowego dalszego, w celu ograniczenia przemieszczenia dogłowowego kości promieniowej.…”

Section: Wstępunclassified

“…Sometimes comminuted radial head fractures cannot be fixated surgically and are an indication for radial head replacement or, in some cases, removal of the fractured head [5]. If removal of the radial head, coronoid process fracture or damage to the medial collateral ligament result in elbow instability, radial head replacement should be considered [6]. The use of an endoprosthesis is also indicated in comminuted radial head fractures and dislocation of the distal radioulnar joint in order to limit the cephalic displacement of the radial bone.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Radial Head Fractures: Outcomes and Complications

Chwedczuk

Piekarczyk

Kwiatkowski

et al. 2016

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Właściwe leczenie złamań głowy kości promieniowej nadal jest obszarem wielu sporów i kontrowersji. W niniejszym badaniu staramy się ocenić wyniki operacyjnej stabilizacji tych obrażeń oraz zidentyfikować najczęstsze powikłania.Materiał i metody. Retrospektywnej analizie poddano dokumentację 63 chorych (25 kobiet i 38 mężczyzn), leczonych w latach 2011-2014. Wyniki leczenia oceniono w skali Broberga i Morreya oraz quickDASH.Wyniki. Spośród 21 chorych ze złamaniem izolowanym, wszyscy ze złamaniem typu II uzyskali wynik bardzo dobry. W typie III złamania, 11 chorych uzyskało wynik zadowalający, a 4 wynik niezadowalający. Spośród 19 chorych, którzy doznali złamania ze zwichnięciem stawu łokciowego, w grupie ze złamaniem typu II odnotowaliśmy same wyniki b. dobre, natomiast w typie III złamania -8 wyników zadowalających i 4 niezadowalające. U 23 chorych ze straszliwą triadą Hot chkissa, w typie II złamania odnotowaliśmy 7 wyników zadowalających, a w typie III -12 wyników zadowalających i 4 wyniki niezadowalające. Powikłania, jakie wystąpiły, to ograniczenie ruchomości stawu łokciowego (59% chorych), dolegliwości bólowe (52,9%), osłabienie siły (35,3%), pourazowa artroza (29,4%), skostnienia pozaszkieletowe (11,8%), brak zrostu (1,5%). Jedenastu chorych wymagało reoperacji.Wnioski. 1. Współcześnie stosowane materiały do zespalania odłamów pozwalają na stabilne zespolenie niemal wszystkich złamań głowy kości promieniowej. 2. O ile istnieją techniczne możliwości zespolenia złamania głowy kości promieniowej, warto podjąć próbę wykonania otwartej repozycji i stabilizacji wewnętrznej. 3. W przypadku braku możliwości zespolenia, leczeniem z wyboru powinna być endoprotezoplastyka głowy kości promieniowej.Słowa kluczowe: głowa kości promieniowej, złamania, straszliwa triada Hotchkissa SUMMARY Background. Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications.Material and methods. The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. The treatment outcomes were assessed according to the Broberg and Morrey rating system and the QuickDASH score.Results. Of 21 patients with isolated fractures, all those with Type 2 fractures demonstrated excellent outcomes. In the group with Type 3 fractures, 11 patients showed satisfactory and 4 unsatisfactory outcomes. Of 19 patients with a fracture combined with elbow dislocation, all those with Type 2 fractures achieved excellent results while in the group with Type 3 fractures 8 patients had satisfactory and 4 had unsatisfactory outcomes. 23 patients were diagnosed with Hotchkiss' terrible triad; 7 of them had sustained Type 2 fractures and showed satisfactory outcomes while those with Type 3 fractures demonstrated 12 satisfactory and 4 unsatisfactory results. Complications included limited elbow mobility (59% of the patients), pain (52.9%), lower muscle s...

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Contribution of Monoblock and Bipolar Radial Head Prostheses to Valgus Stability of the Elbow

Cited by 175 publications

References 17 publications

Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: Good outcome after 1–4 years follow-up in 11 patients

Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: Good outcome after 1–4 years follow-up in 11 patients

Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?

Surgical Treatment of Radial Head Fractures: Outcomes and Complications

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