Silicone Rubber Replacement of the Severely Fractured Radial Head

Carn, Ronald M.; Medige, John; Curtain, Daniel; Koenig, Andrew

doi:10.1097/00003086-198608000-00040

Cited by 70 publications

(39 citation statements)

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“…This treatment is still considered as standard in cases of comminuted fractures (16,39,65,71). Other authors consider it essential to reconstruct the radial head by means of osteosynthesis (22) or to replace it with a prosthesis (12,22,25,32,43,46,52,60,68,77).…”

Section: Resultsmentioning

confidence: 99%

“…Rigid radial head prostheses (metal, ceramic, ultra-high molecular weight polyethylene) give better load transfers at the RC joint than silicone radial head prostheses (12,29,38,51,52). Moreover, silicone implants are not only unable to resist axial forces without showing deformations (12,29,52), they are also incapable of providing valgus stability in MCL deficient elbows (51) .…”

Section: Biomechanicsmentioning

confidence: 99%

“…Moreover, silicone implants are not only unable to resist axial forces without showing deformations (12,29,52), they are also incapable of providing valgus stability in MCL deficient elbows (51) .…”

Section: Biomechanicsmentioning

confidence: 99%

“…A number of these complications may result from incorrect length and orientation in reconstruction of the radial head (12,51,77), and further experimental research is necessary to assess the importance of these factors.…”

Section: Biomechanicsmentioning

confidence: 99%

“…Most controversies concern the treatment of displaced and comminuted radial head fractures, where reconstructions (12,22,25,32,43,46,52,60,68,77) and resections (16,39,65,71) are balanced.…”

Section: Introductionmentioning

confidence: 99%

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Current Concepts Review

Harcke¹,

Kumar²

1991

Journal of Pediatric Orthopaedics

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The treatment of simple radial head fractures type Mason-Hotchkiss 1 and 2 is unequivocal. In the case of a displacement of less than 2 mm (MasonHotchkiss 1), functional conservative treatment is indicated. If the displacement is more than 2 mm (Mason-Hotchkiss 2) internal fixation is indicated, combined with treatment of the soft-tissue injuries. The treatment of comminuted radial head fractures Mason-Hotchkiss type 3 is more controversial, as they are usually associated with ligament injuries. Conservative treatment appears to have unsatisfactory results. Opinions differ on surgical treatment, i.e. 1) excision of the radial head ; 2) reconstruction by means of internal fixation ; 3) excision and reconstruction with a prosthesis. Basic experimental research on human cadaver elbows shows the importance of the conservation of the radial head, especially in case of associated soft tissue injuries. In most cases a stable osteosynthesis is impossible, and in case of associated ligament disruptions, resection and reconstruction by means of a rigid radial head prosthesis should be considered. Experimental research demonstrates promising results for rigid radial head prostheses in human cadaver elbows with a resected radial head and failing medial collateral ligament. Short-term clinical studies seem to confirm this, but long-term results are as yet unknown.

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Section: Resultsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Current Concepts Review

Harcke¹,

Kumar²

1991

Journal of Pediatric Orthopaedics

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Radiusköpfchenresektion bei Mehrfach- und Trümmerfrakturen

1993

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Between 1974 and 1989 39 patients with multi-fragmentary fractures of the head of the radius or radial neck fractures were treated by resection of the radial head at the Department of Trauma and Reconstructive Surgery (UKE-University Hospital Hamburg). Follow-up of 22 patients after 0.5 to 15 years (average 7.8 years) by means of patient documents, actual condition, functionally re-examination of the upper limb and evaluation of the roentgenological changes revealed 22.8% good, 63.6% acceptable and 13.6% poor results according to a modified scoring system. Characteristic complications after excision of the radial head are the increase of the carrying angle of the elbow, the proximal migration of the radius and the loss of grip strength. Due to a critical review of the international literature prosthetic replacement by now does not lead to convincing better results. Reoperations may be mandatory to remove the implant because of tissue reactions or failure of the implant.

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