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

Yu, Shiyong; Yan, Hede; Ruan, Hongjiang; Wang, Wei; Fan, Cunyi

doi:10.1007/s00264-014-2594-5

Cited by 21 publications

(11 citation statements)

References 35 publications

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“…Some authors raised the question of the validity of the common procedure of the resection of the radial head when multifragmentary fractures occur [37]. Late complications of this procedure are well documented in literature such as pain, instability, proximal migration of the radius, strength decrease, osteoarthritis and valgus deformity [7].…”

Section: Discussionmentioning

confidence: 99%

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Mason type II and III radial head fracture in patients older than 65: is there still a place for radial head resection?

et al. 2015

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Radial head resection remains a good option when a radial head fracture occurs in elderly patients, taking into account the influence of poor bone quality and comorbidities on the outcome. Radial head excision is not indicated in the presence of associated lesions, because of the risk of residual elbow instability; complications associated with advanced age must be considered and a strict follow-up granted.

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Section: Discussionmentioning

confidence: 99%

“…Implantation of radial head prosthesis in young patients has different implications to those relating to patients of advanced age. The mean follow-up for radial head replacement reported in literature is of almost 5 years; studies are mainly retrospective, lacking in large series numbers [37].…”

Section: Discussionmentioning

confidence: 99%

Mason type II and III radial head fracture in patients older than 65: is there still a place for radial head resection?

et al. 2015

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“…Similar to what is being done in the prospective, randomized, multicentre trial BRAMBO trial^ [67], the challenge in the coming years will be to perform and publish high level of clinical studies in order to obtain reliable results and provide clear recommendations for surgeons. This will require strict adherence to the quality standards developed for observational studies [68]: clear definitions of outcomes (1) and the assessment of outcomes (2), an independent assessment of the outcome parameters (3), sufficient follow-up (4), no significant loss to follow-up (5), the identification of important confounders, and prognostic factors (6). A task of this magnitude calls for collective responsibility among authors and journal editors for transparent, comprehensive, and standardized reporting of all outcomes and study characteristics.…”

Section: Future Directionsmentioning

confidence: 99%

“…However, the treatment of Mason III fractures remains controversial [2--4]. Arthroplasty or simple RH resection is an alternative in cases of non-reconstructable RH fractures [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Radial head arthroplasty: a historical perspective

Laumonerie

Tibbo

Reina

et al. 2018

International Orthopaedics (SICOT)

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There has been lively debate regarding the rationale behind the use of radial head arthroplasty (RHA) for more than 80 years. Currently, its primary indication is for treatment of non-reconstructible RH fractures. The first RH implant, released in 1941, was a ferrul cap used to prevent heterotopic ossification. Biomechanical studies in the 1980s stimulated a revolution in RHA design by promoting modular implants that replicated the native bony anatomy of the elbow. Subsequent data-driven evolution in design led to the creation of a variety of devices that also accommodated for common ligamentous injuries occurring at the time of RH fracture. Despite significant advances in our understanding of complex elbow instability, improvements in implant design have to make RHA the gold standard for treatment of non-reconstructible RH fractures. The challenge in the coming years will be to perform high-level clinical studies in order to obtain consensus regarding the most appropriate treatment for comminuted RH fractures.

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“…radial head excision, interpositional arthroplasty, excision of synostosis or ulnar nerve transposition via a medial approach. Although there is no agreement on the superiority of the radial head replacement over simple excision [13], we always replaced the radial head with a prosthesis (KPS) designed by the senior author. Release of the ulnar nerve was consistently combined with its anterior transposition and was never performed prophylactically despite recent reports underlining its benefit [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The column procedure preserves elbow stability on biomechanical testing

Podgórski

Kordasiewicz

Pomianowski

2020

International Orthopaedics (SICOT)

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The effect of open release of a post-traumatic elbow contracture on the stability of the joint has not been so far studied in vivo. Resection of elbow joint capsule, the key element of surgery, was reported to have no effect on the stability of cadaveric elbows. The joint capsule is yet known to participate in maintaining elbow stability as one of secondary stabilizers. Methods We assessed elbow joint laxity in 39 patients who underwent an open contracture release via the 'column procedure' described by B. Morrey and P. Mansat within the preceeding three to nine months. The measurements were taken with an apparatus designed particularly for this experiment according to the predetermined protocol. A preliminary part of the experiment showed that there was no significant difference between laxity of two elbow joints in healthy volunteers. Laxity of the operated elbows could be then compared with the contralateral joints. Results Mean absolute difference of laxity between healthy and operated elbows was 1.55°(0.1°-4.1°, SD = 1.1) being significantly lower than 2°, p = 0.0056. The difference of the joint laxity between the operated and healthy elbows did not differ statistically significantly by more than 0.6°from the difference of the laxity of two healthy elbows and, therefore, is not clinically noticeable. Conclusions Our experiment confirmed that the 'column procedure' is a safe procedure which does not compromise the stability of the elbow joint.

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

Cited by 21 publications

References 35 publications

Mason type II and III radial head fracture in patients older than 65: is there still a place for radial head resection?

Mason type II and III radial head fracture in patients older than 65: is there still a place for radial head resection?

Radial head arthroplasty: a historical perspective

The column procedure preserves elbow stability on biomechanical testing

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