Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization

Bain, Gregory I.; Ashwood, Neil; Baird, R. D.; Unni, R.

doi:10.2106/jbjs.d.02710

Cited by 44 publications

(23 citation statements)

References 13 publications

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“…Depending on the fracture pattern and associated soft-tissue injury, several types of treatment exist for fractured radial head [2,17]. The radial head prosthesis used in this study for comminuted radial head fractures has an uncemented titanium stem, a 15°angulated neck, is modular, and has a pyrocarbon head [1].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to restore radiocapitellar contact through repair or replacement of the radial head when treating unstable fracture dislocations of the elbow, such as those associated with injury of the interosseous ligament of the forearm (an Essex-Lopresti lesion) or posterior dislocation of the elbow with fractures of the radial head and coronoid process (the so-called terrible triad of the elbow [20]. Biomechanical studies have demonstrated that metallic prostheses can reproduce the loads across the elbow more closely than silastic prostheses [2]. Acrylic, stainless steel, silastic, pyrocarbon, and articulating CoCr prostheses have been developed, and a variety of results have been reported.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comminuted Radial Head Fractures Treated with Pyrocarbon Prosthetic Replacement

Lamas

Castellanos

Proubasta

et al. 2010

Hand (New York, N,Y.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comminuted Radial Head Fractures Treated with Pyrocarbon Prosthetic Replacement

Lamas

Castellanos

Proubasta

et al. 2010

Hand (New York, N,Y.)

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“…Because today's standards demand a greater degree of satisfactory function, ORIF is being widely used, and radial head prosthesis replacement is used in selected cases. Some authors believe that the radial head is not only important for humeroradial joint [1,14], but also for the stability of distal ulnoradial joint. In fractures of the radial head, especially complicated with forearm soft tissue injury, proximal migration of radius appears frequently and results in wrist strength weakening and chronic elbow pain.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III

Ruan¹,

Fan²,

Liu³

et al. 2007

International Orthopaedics (SICO

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Although several treatment options for radial head fractures are available, no clear solutions exist. In this study we therefore compare open reduction and internal fixation (ORIF) with bipolar radial head prosthesis replacement in treatment of radial head fractures of Mason type III. Cement stem and bipolar radial prosthesis were used to treat 12 fresh cases and two old cases of Mason type III radial head fracture. As a control group, another eight cases of radial head type III fracture were treated with ORIF with cannulated screws and Kirschner (K) wires. The 14 patients who received radial head prosthesis replacement were followed-up for 15.9 months (range 10-27 months). According to elbow functional evaluation criteria by Broberg and Morrey, we found excellent results in nine cases, good in four, and fair in one. Mean follow-up of the eight cases in the ORIF group was 14 months (range 10-21 months), with good results in one case, fair in four, and poor in three. The result was good or excellent in 92.9% of prosthesis replacement patients and in 12.5% of ORIF patients. This difference is statistically significant (P=0.0004; Fisher's exact test). We concluded that bipolar radial head prosthesis replacement is better than ORIF in treatment of Mason type III radial head fracture.

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“…Currently, several models of radial head prosthesis are in use, including monopolar, bipolar, cemented, or press-fit implants. Regardless of design, recent literature has favored metal prostheses [1,24,30,36,37] despite evidence of altered joint contact pressures in radiocapitellar articulations involving metallic implants [18]. ''Overstuffing'' as a result of an excessively large prosthesis has received considerable attention [4,40] and problems of persistent pain and radiographic evidence of arthritis ( Fig.…”

Section: Introductionmentioning

confidence: 99%

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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Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization

Abstract: The results of treatment of Mason type-III radial head fractures with a monoblock titanium radial head prosthesis and soft-tissue reconstruction are satisfactory. Early mobilization of the elbow is important for the restoration of elbow range of motion and function.

Cited by 44 publications

References 13 publications

Comminuted Radial Head Fractures Treated with Pyrocarbon Prosthetic Replacement

Comminuted Radial Head Fractures Treated with Pyrocarbon Prosthetic Replacement

A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III

Is a Silastic Radial Head Still a Reasonable Option?

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