The acute bipolar radial head replacement for isolated unreconstructable fractures of the radial head

Abstract

For the acute treatment of radial head fractures, radial head arthroplasty can be considered if open reduction and internal fixation is not technically possible and if simple radial head resection is contraindicated. We report our experience with a bipolar Judet radial head prosthesis. After a mean follow-up of 41.7 months, 16 patients were assessed following radial head replacement. The outcome was assessed clinically, functionally, and radiographically. Outcome was satisfactory in 87.5% of cases. The mean post-operative ranges of motion were greater than the functional arcs both in flexion-extension and in pronation-supination, and the results did not appear to be influenced in a significant way by the type of original lesion. All elbows were stable. The main complication was the development of heterotopic ossifications. Bipolar radial head prosthesis represents a suitable option for acute treatment of unreconstructable radial head fractures, either isolated or associated with elbow dislocation and in the absence of other bony lesions.

Functional outcomes post-radial head arthroplasty: a systematic review of literature

“…As such, most of these studies reported only short-to medium-term followup. Most of the studies were carried out in Europe [13,[17][18][19][20][21][22][23][24][25]35,36,[43][44][45][46][47][48][49][50] [21] (4.76%). The radial head implants varied in design with respect to their modularity and component mobility.…”

“…There were a few direct injuries to the elbow (7.6%) and only two cases (0.8%) of sports-related injuries. The dominant hand was involved in 54.3% of participants in 13 [21,34,[43][44][45][46]48,49,[51][52][53][54][55]57,58] studies that reported hand dominance.…”

“…The total MEPI scores can range from 5 to 100, with higher 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 [35,36,[43][44][45]47,49] 24.46% (96) Titanium [21,[53][54][55]57] 18.16% (71) Vitallium [46,51,58] 13.55% (53) Katalyst [59] 7.67% (30) Link [50] 4.60% (18) n, number of radial head implants. [63] was reported in nine out of 21 studies [34,[43][44][45]48,51,52,58,59] (Table 7). Comprising a regionspecific outcome measure, DASH evaluates the symptoms, daily activities, sleep and social and work function based on 21 questions rated on a Likert scale of 0 to 4 [63].…”

“…Residual pain as an outcome measure post RHAP was reported in 16 out of 21 studies [21,36,43,44,[46][47][48][49][50][52][53][54]58]. It was most commonly measured using a visual analogue scale (VAS) of 0 to 10, where 0 represents no pain and 10 is the worst pain ever, or with the ASES-e pain subscale [65].…”

“…There were seven cases of wrist pain that were not found to be associated with radiological evidence of altered ulnar variance [21,49,58]. In eight out of 21 studies [21,43,[48][49][50]52,58,59] that reported on patient satisfaction, the outcome was found to be satisfactory [21,43,[48][49][50]52,58,59]. Patient satisfaction was measured with a VAS of 0 to 10 or with the ASES-e satisfaction subscale.…”