Elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture: Efficacy of prosthetic replacement and ligament repair

Jensen, Steen Lund; Olsen, Birgit Anette; Tyrdal, Stein; Søjbjerg, Jens Ole; Sneppen, O

doi:10.1016/j.jse.2004.05.009

Cited by 95 publications

(59 citation statements)

References 29 publications

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“…The radial head is an important secondary valgus restraint [16,25] and can bear up to 60% of the load transmitted from the forearm [9]. The goals of treating radial head fractures are to restore stability, preserve motion, and maintain length of the radius.…”

Section: Introductionmentioning

confidence: 99%

“…In the normally functioning elbow, the anterior band of the medial ulnar collateral ligament (MUCL) provides the primary stabilization against valgus force [6,12,16,23,32]. Transection of the anterior bundle alone is sufficient to create demonstrable instability on the application of a valgus force and abnormally high radiocapitellar pressures [28].…”

Section: Introductionmentioning

confidence: 99%

“…The interosseous membrane (IOM) functions as another primary stabilizer of the elbow by providing longitudinal restraint to proximal migration of the radius during axial loading [21]. Radial head fracture or fracture/ dislocation is attended by a high incidence of ligament damage and repair of the collateral ligaments is critical to re-establishing normal joint biomechanics during surgical treatment of these injuries [14,16]. In an in vitro model, Pollock et al recently demonstrated repair of the lateral ulnar collateral ligament (LUCL) and MUCL restored elbow stability to varus and valgus stress, even in the presence of a displaced Type II coronoid fracture, suggesting evaluation and repair of the collateral ligaments is essential in cases of persistent instability [29].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is a Silastic Radial Head Still a Reasonable Option?

Maghen

Leo

Hsu

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background The importance of the radial head to elbow function and stability is increasingly apparent. Although preservation of the native radial head is preferred, severely comminuted fractures may necessitate resection or arthroplasty. Silastic radial head arthroplasty has been condemned on the basis of several sporadic reports of silicone synovitis. However, problems of ''overstuffing,'' cartilage wear, and motion loss are becoming apparent with metal prostheses, indicating this also is not an ideal solution. Thus, the choices remain controversial. Questions/purposes We asked whether intact or reconstructed primary elbow stabilizers permit use of silastic radial head implants without fragmentation, failure, and silicone synovitis. Methods We retrospectively reviewed 23 patients with unreconstructable radial head fractures who were treated with silastic radial head arthroplasty and concomitant repair and/or reconstruction of the medial ulnar collateral ligament and/or lateral ulnar collateral ligament. Analysis included range of motion, pain, stability, and radiographic assessments; Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire; and Mayo Elbow Performance Score (MEPS). The minimum followup was 16 months (average, 69.6 months; range, 16-165 months). Results At last followup, the mean elbow flexion was 145°, extension 11°, supination 80°, and pronation 83°. The mean MEPS score was 88.9. The mean DASH score was 11.8. There were eight reoperations, none resulting from failure of the radial head implants. Conclusions These results demonstrate silastic radial heads can be used with low complication rates and without evidence of synovitis when concomitant elbow ligament repair or reconstruction is performed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is a Silastic Radial Head Still a Reasonable Option?

Maghen

Leo

Hsu

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Biomechanical studies have also shown the importance of the radial head in varus and posterolateral stability of the elbow [25][26][27][28]. In the presence of a torn MCL, obvious valgus instability, and associated lesions of the LCL and coronoid process on the affected limb, radial head replacement arthroplasty should be performed to provide stability to the elbow [29].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of radial head resection and prosthetic replacement in surgical release of stiff elbows

Yan

Ruan

et al. 2014

International Orthopaedics (SICOT)

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“…The theoretic accuracy of the MATMI is 0.70 o in flexion, 0.35 o in deviation, and 0.47 o in rotation. 36 In our set-up position and torque were measured in radioulnar deviation, flexion-extension, and internal/external rotation. To make measurements unambiguous and to avoid right/left confusion radial deviation, dorsal flexion, and internal rotation were designated as positive.…”

Section: Methods For Testingmentioning

confidence: 99%