Radial Head Reconstruction in Elbow Fracture-Dislocation: Monopolar or Bipolar Prosthesis?

Hartzler, Robert U.; Morrey, B.F.; Steinmann, Scott P.; Llusá-Pérez, Manuel; Sánchez-Sotelo, Joaquín

doi:10.1007/s11999-014-3672-0

Cited by 46 publications

(18 citation statements)

References 18 publications

(40 reference statements)

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“…Conversely, young patients have a high risk of revision surgery after prosthetic head implantation (13). Many artificial radial head designs have been developed, making it possible to choose between monopolar and bipolar versions (14); however, the ideal model for guaranteeing optimal tracking during movement on the capitellum remains to be established (15). Given these considerations, anatomical features of the radius are unique and very difficult to reproduce; moreover, even were a perfect prosthesis available, this should, crucially, be inserted in the correct position (6).…”

Section: Discussionmentioning

confidence: 99%

Mason type 3 radial head fractures: proposal of a synthesis technique using bioabsorbable thread

Salvi¹

2016

Joints

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Multifragmentary fractures of the radial head (Mason type 3) are challenging for the surgeon. They are usually treated by means of complete removal of the injured head and sometimes by implantation of a metal prosthesis. Indeed, the bone fragments are often too small to allow stabilization through screws or even wires. The Author proposes an alternative technique, tested on a sawbone model, in which bioabsorbable thread is used, introduced in a figure-of-eight fashion. A review of the literature is provided.

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Section: Discussionmentioning

confidence: 99%

Mason type 3 radial head fractures: proposal of a synthesis technique using bioabsorbable thread

Salvi¹

2016

Joints

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“…5-7 Interestingly, a number of studies have found conflicting evidence. In this study, we will summarise our interpretation of the available literature on the basic science of elbow stability.…”

Section: A Few Basic Conceptsmentioning

confidence: 99%

“…Alternatively, a bipolar prosthesis may be used. 5 However, bipolar implants may be more prone to elbow subluxation 14 and also carry the risk of polyethylene wear. Our preference is to use monopolar implants whenever possible.…”

Section: Management Of Individual Structuresmentioning

confidence: 99%

Complex elbow instability: surgical management of elbow fracture dislocations

Sánchez-Sotelo

Morrey

2016

EFORT Open Reviews

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There are three main patterns of complex elbow instability: posterolateral (terrible triad), varus posteromedial (anteromedial coronoid fracture with lateral collateral ligament complex disruption), and trans-olecranon fracture dislocations.Radial head fractures, in the setting of complex elbow instability, often require internal fixation or arthroplasty; the outcome of radial head replacement is dictated by adequate selection of the head diameter, correct restoration of radial length, and proper alignment and tracking.Small coronoid fractures can be ignored. Larger coronoid fractures, especially those involving the anteromedial facet, require fixation or graft reconstruction, particularly in the presence of incongruity.The lateral collateral ligament complex should be repaired whenever disrupted. Medial collateral ligament disruptions seem to heal reliably without surgical repair provided all other involved structures are addressed.The most common mistakes in the management of trans-olecranon fracture dislocations are suboptimal fixation, lack of fixation of coronoid fragments, and lack of restoration of the natural dorsal angulation of the ulna.Cite this article: Sanchez-Sotelo J, Morrey M. Complex elbow instability. EFORT Open Rev 2016;1:183-190.

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“…Hartzler et al . collected kinematic data on six fresh‐frozen cadaveric upper extremities and concluded that both monopolar and bipolar radial head prostheses are effective in improving valgus and external rotation laxity to the elbow, regardless of coronoid status.…”

Section: Definition Classification and Treatment Principles Of The Tmentioning

confidence: 99%

“…He also pointed out that, because these injuries are commonly seen in younger patients, longer-term studies are needed to determine whether the apparent benefits of radial head arthroplasty are offset by late complications of arthroplasty, such as loosening. Hartzler et al collected kinematic data on six fresh-frozen cadaveric upper extremities and concluded that both monopolar and bipolar radial head prostheses are effective in improving valgus and external rotation laxity to the elbow, regardless of coronoid status 16 .…”

Section: Classification and Treatment Principles Of Radial Head Fractmentioning

confidence: 99%

Anatomy, Definition, and Treatment of the “Terrible Triad of the Elbow” and Contemplation of the Rationality of this Designation

Xiao

Jia

et al. 2015

Orthopaedic Surgery

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In the realm of orthopaedics, the terrible triad of the elbow is infamous, not simply because the prognosis is poor for most patients, but also, maybe to a greater extent, because the unique name of this malady attracts considerable attention and interest in both doctors and patients. The adjective terrible is bestowed on an elbow triad that comprises three coexisting complicated traumas; namely, radial head and ulnar coronoid process fractures and posterior dislocation of the elbow joint. In this review, the classification, treatment principles and prognosis for different forms of management of the radial head and ulnar coronoid process fractures and the ligaments lesions are introduced sequentially and various surgical procedures and their efficacy are discussed. This triad has long given orthopedic surgeons headaches. Nonetheless, in recent years a series of anatomical mechanical studies on the elbow joint have been published and there have been several breakthroughs in surgical techniques for managing this elbow triad. This review examines some memorable millstones and unveils trends in the current clinical norm for this triad. The accomplishments achieved recently have reportedly resulted in enhanced prognoses in the last two or three years compared with previous years. It is therefore high time to revise our thoughts about the justice and accuracy of defining this triad of the elbow as terrible. Lastly, we may safely conclude that the terrible triad of the elbow is much less terrible than previously, provided the commonly approved clinical approaches are undertaken.

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Radial Head Reconstruction in Elbow Fracture-Dislocation: Monopolar or Bipolar Prosthesis?

Abstract: The data from our cadaveric model support the use of either implant type in terrible triad injuries if the collateral ligaments are intact or reconstructed.

Cited by 46 publications

References 18 publications

Mason type 3 radial head fractures: proposal of a synthesis technique using bioabsorbable thread

Mason type 3 radial head fractures: proposal of a synthesis technique using bioabsorbable thread

Complex elbow instability: surgical management of elbow fracture dislocations

Anatomy, Definition, and Treatment of the “Terrible Triad of the Elbow” and Contemplation of the Rationality of this Designation

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