Radial head prosthesis: results overview

Abstract

Background/purposeRadial head replacement is frequently used in treatment of radial head fractures or sequela. Impossibility to restore a correct anatomy, acute elbow traumatic instability and failure of osteosynthesis hardware are the most common indications. The authors describe their case studies and results on the implantation of various radial head prostheses.MaterialsBetween June 2005 and June 2016, 28 radial head prostheses were implanted in the same number of patients with an average follow-up of 49 months (6–104). Indications for implantation were: Mason type III and IV radial head fractures and post-traumatic arthritis due to failure of previous treatments. Monopolar prostheses were used and were press-fit implanted via Kaplan’s lateral access and Kocher’s anconeus approach to the humeroradial joint. At the follow-up, assessments were made of the pain, according to the visual analogic scale, range of motion (ROM), stability and functionality according to the Mayo Elbow Performance Score, presence of osteolysis and mobilization during radiography tests, personal satisfaction of the patients, Disabilities of the Arm, Shoulder and Hand and Patient-Rated Wrist Evaluation outcomes measurements.ResultsAt the follow-up, we recorded an average level of pain of 1.8 in patients under acute treatments for radial head fractures and a marked reduction in the remaining cases from 6.7 to 2.1. ROM was found on average to be 107° of flexion–extension and 159° of pronosupination. Personal satisfaction was good–excellent in 23 cases. There was no case of infection; removal of the implant was necessary in three cases due to mobilization of the stem and oversized implants. In six cases, bone resorption was seen at the level of the prosthetic collar and it was in all cases asymptomatic.ConclusionsThe results of this study suggest that the use of prostheses, if well positioned, is a valid solution in the treatment of secondary arthritis and fractures of the radial head with poor prognosis, with good results in the reduction of pain, recovery of movement and improved quality of life.

Acute Joint Blockage due to Abrasion-Related Dislocation of a Silastic Radial Head Prosthesis: A Histological Examination after 14 Years of Durability

“…This suggest that the use of prostheses, if well positioned and selected, is a valid solution in the treatment of complex fractures of the radial head with poor prognosis. Good results in the reduction of pain, recovery of movement, and improved quality of life were shown [ 4 , 6 ]. This result is supposedly limited in time, as shown in our case report.…”

“…Therapy can include osteosynthetic treatment, resection of the entire radial head, or implantation of a radial head prosthesis [ 1 – 3 ]. There are various implants for the latter [ 4 ]. A study by Maghen et al showed no complications in a follow-up period of an average of five years after implantation of silastic radial head prostheses, with simultaneous surgical restoration of the ligamentous apparatus of the elbow [ 5 ].…”

Radial Head Resection versus Arthroplasty in Unrepairable Comminuted Fractures Mason Type III and Type IV: A Systematic Review

“…For most of authors, mid term follow-up has shown satisfactory results in range of motion recovery (average flexion-extension arc of motion: 116°). Good results in DASH scores (from 7 to 24) and MEPS scores (from 79 to 100) and low VAS pain evaluation scale (from 0 to 2.2) are reported [ 13 – 32 ]. A certain loss of grip strength compared to contralateral side is often described (average loss of strength: 10% respect to the contralateral side).…”

Fracture Pattern Influences Radial Head Replacement Size Determination Among Experienced Elbow Surgeons

“…Rh prosthetic replacement (RhR) is indicated for comminuted Rh fractures in association with other elbow fractures, with lesions of the interosseous membrane or with elbow instability [2][3][4][5]. This surgical treatment can provide satisfactory results at long-term follow-up [6][7][8][9].…”