The applicability of the mayo clinic congruent radial head plate: cadaveric study

Abstract

In the last few years, several anatomical plates have been introduced to improve the results of ORIF in Mason Type II and III radial head fractures. However, no study analyzed whether currently used plates match adequately the profile of the proximal radius in the "safe zone". In the present investigation, we evaluate the congruence between the proximal radius and a currently used plate. Forty-four radial dried cadaveric bones were analyzed. The plate congruence was evaluated qualitatively and quantitatively. The congruence of the tested plate with the proximal radius was good in 27.3% of specimens, while it was moderate or poor in the remaining 43.2% and 29.5% of cases, respectively. The profile of the proximal radius in the "safe zone" shows substantial morphologic variations which should be taken into account to avoid a malunion of the proximal radius. A preoperative radiograph of the contralateral uninjured radius may be helpful in order to select the most appropriate plate profile in comminuted radial head and neck fractures.

Anatomical Variations of the Proximal Radius and Their Effects on Osteosynthesis

“…These investigations showed that none of the tested plates exhibited good congruence to the safe zone in most cases analyzed, nor was a significant improvement found in the plate-bone congruence after plate bending. 12,13 In keeping with this, our results suggest that if the different morphological types of the proximal radius are not taken into account by the plate design, an osteosynthesis of the radial head may fail to reconstitute the original morphology, especially when the severity of injury causes a loss of anatomical landmarks. We found that in the presence of a type A radius, the positioning of a pre- 17,20 -22 we believe that preoperative templating of the contralateral radius may be useful before operating on comminuted Mason type II and III fractures.…”

“…12 Briefly, we positioned a currently available plate (Mayo Clinic Congruent Radial Head Plate; AcuMed, Hillsboro, OR) in the center of the safe zone according to standard surgical technique. In cases showing a mismatch between plate and bone, the implant was positioned adherent to the radial head circumference.…”

“…Once the epiphyseal portion of the plate was tightly fixed to the radial head, we performed a qualitative and quantitative evaluation of the boneplate congruence in the metadiaphyseal portion of the safe zone of the radius. 12 In particular, the bone-plate congruence was classified as poor when there was a clear mismatch between the plate and the radius profile, moderate when the plate was in contact with the underlying bone only at the level of 1 of the 2 holes of the plate, and good when both the proximal and distal holes of the plate were in contact with the underlying bone (Figs. 2, 3).…”

“…A previous study evaluating the congruence between a precontoured plate and the underlying bone in the safe zone of the proximal radius found that good bone-plate congruence was present in only 27% of specimens. 12 In addition, a study investigating the anatomical fit of 6 different plates in 22 cadaveric radii showed that none of the tested devices exhibited an adequate fit in most cases. 13 These findings suggest that substantial morphologic variations of the proximal radius exist among subjects and that such anatomical variations should be considered when restoring the proper anatomy of the proximal radius.…”

Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones

“…Furthermore, qualitative evaluation was used in some studies. In their studies, Giannicola et al [22,23] evaluated the congruency between an anatomic plate and proximal radius on cadaveric bones by two independent observers and congruence was classified as good, moderate or poor. In this study, the volume of free space between the plate and bone was used as a criteria.…”