Is the distal radioulnar variance useful for identification of radial head prosthesis overlengthening? A cadaver study

Wegmann, Kilian; Zhang, Wei; Strauss, Volker; Ries, Christian; Müller, Lars Peter; Burkhart, Klaus J.

doi:10.1186/s40001-016-0196-y

Cited by 6 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…So, if in question, X-ray imaging of both wrists may add some information. However, in our own study on the influence of overlengthening on ulnar variance and loss of parallelism, we could not replicate these results [ 25 ]. Several other authors have done anatomical studies to define anatomical landmarks that can be used on X-ray to identify or quantify overlengthening [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 85%

Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system

Wegmann

Hackl

Leschinger

et al. 2020

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Background Radial head arthroplasty is a common procedure in elbow surgery. It has been shown to be of benefit for the patients, but there also are relevant complications that should be prevented if possible. One significant complication is overlengthening of the radial head prosthesis. In overlengthening, the head of the prosthesis overextends the physiological level of the native radial head and leads to overcompression in the radiohumeral joint. Rapid erosion and arthritic changes may then impede the clinical outcome. The incidence of overlengthening is not precisely known, but estimations range to up to 20% of all implanted prostheses. Methods The present review discusses the available body of literature on overlengthening and lines out a classification system that may be used to guide treatment algorithms. The classification is based on the personal experiences of the author during their clinical practice. Results In low-grade overlengthening (type I) conservative treatment can be an option. In Types II–IV usually revision surgery is needed. Depending on the state of the capitulum and joint stability, it is possible re-implant a prosthesis, or rely on implant removal alone. Discussion The present review aimed at shedding light into overlengthening as a complication radial head replacement and to help identify and treat it.

show abstract

Section: Introductionmentioning

confidence: 85%

Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system

Wegmann

Hackl

Leschinger

et al. 2020

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…The Kocher approach was used in all procedures. The height of the prostheses was levelled at the posterolateral edge of the coronoid, according to current recommendations [13,[21][22][23]. Implantation was performed according to the manufacturer's recommendations.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Prosthetic replacement of the radial head

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Radial head replacement is an established option in patients with comminuted radial head fractures and complex elbow trauma. While studies demonstrated that asymptomatic radiolucencies around the stem are common, the incidence and clinical significance of bone loss at the proximal part of the radius, just distal to the neck of the prosthesis (collar resorption), is unknown. Objectives The aim of this retrospective study was to analyse the incidence of collar resorption after radial head replacement and investigate whether this correlates with specific patient characteristics such as gender, age, indication for index surgery and the size of implant used. Materials and methods The study group consisted of 30 patients (average age 60.1 years) having undergone prosthetic replacement with a monopolar press-fit implant of the radial head at an average follow-up of 23 months. Indications for surgery included trauma sequelae or revision in 16 patients and acute, unreconstructable fractures of the radial head in 14 cases. Symptoms of loosening and revision surgery were recorded. Radiographs were analysed for signs of lucency between the bone and the implant as well as for signs of resorption of bone mass around the neck (section 1). These values were correlated with age, gender, indication for index surgery and size of implant. Results In all, 28/30 (93.3%) prostheses showed proximal osteolysis around the neck of the shaft. Of the 30, one prosthesis presented signs of shaft loosening. The average amount of osteolysis was 8.78% (range 0–26.1%; ±6.0%) of the overall length of the prosthetic shaft (OL). There was no significant difference (p = 0.49) between the amount of resorption in section 1 between the primary fracture cases (8.75 ± 4.5%; range 1.2–15.8%) and the group of secondary implantations due to degeneration or fracture sequelae (8.8 ± 7.2%; range 0–26.1%). Furthermore, the analysis did not reveal any statistically relevant correlations between the amount of neck resorption and the other cohort characteristics (age, gender, size of the components). Conclusions In the study cohort, a high amount of osteolysis/bone resorption was assessed around the neck of the press-fit radial head prosthesis used. However, no significant correlation between collar resorption, patient demographics and indication for index surgery was found at short-term follow-up.

show abstract

Resultados clínicos de la artroplastia radial en la tríada terrible de Hotchkiss, a propósito de 47 casos

Jiménez-Martín¹,

Contreras-Joya²,

Navarro-Martínez³

et al. 2020

Revista Española de Cirugía Ortopédica y Traumatología

View full text Add to dashboard Cite

Is the distal radioulnar variance useful for identification of radial head prosthesis overlengthening? A cadaver study

Cited by 6 publications

References 28 publications

Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system

Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system

Prosthetic replacement of the radial head

Resultados clínicos de la artroplastia radial en la tríada terrible de Hotchkiss, a propósito de 47 casos

Contact Info

Product

Resources

About