Radial head replacement with titanic prosthesis for the treatment of comminuted fracture of the radial head associated with elbow instability
- VernacularTitle:人工桡骨头置换治疗肘关节不稳定的桡骨头粉碎性骨折
- Author:
Xieyuan JIANG
;
Ting LI
;
Lidan ZHANG
- Publication Type:Journal Article
- Keywords:
Radius fractures;
Arthroplasty, replacement;
Joint instablity;
Elbow joint
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy of radial head replacement with titanic prosthesis for comminuted fractures of the radial head associated with elbow instability. Methods From 2000 to 2003, a total of 18 patients, 13 men and 8 women (mean age, 34.8 years, range, 24-47 years) underwent radial head replacement with titanic prosthesis for comminuted fractures associated with elbow instability. All were the close fractures, left elbow in 8 and right elbow in 10 cases. 3 patients suffered multiple fractures in ipsilateral elbow, including proximal comminuted fracture of radius in 1, fracture of coronoid process in 2. 4 patients suffered simultaneous fracture in ipsilateral upper extremity, including distal fracture of radius in 3, fracture of surgical neck of humerus in 1. According to Mason classification, 10 fractures were of type Ⅲ, 7 of type Ⅳ, and 1 with Essex-Lopresti injury. 4 cases were old fractures and dislocations, the other 14 were of fresh injuries within 2 weeks. Operations were undertaken averagely in 9 days after injury (range, 4-26 days). Results Patients were followed from 12 to 44 months (average, 29 months). According to Broberg and Morrey scoring system, 8 patients (44.4%) were rated as excellent, 8 (44.4%) as good, 1 (5.6%) as fair, and 1 (5.6%) as poor. The rate of excellent and good results was 88.9%. No cases of infection, neural injury, foreign body reaction, exacerbation of cubitus valgus or deformity of wrist was found. On X-ray films, all of the titanic radial head prosthesis were stable, no shortening or proximal migration of radius, or subluxation of distal radioulnar joint was found. No sign of inflammatory reaction was noted. Mild heterotopic ossification was found in 6 elbows, but no distinct resulted limitation of locomotion. Conclusion The radial head replacement with titanic prosthesis provides an effective method for the treatment of comminuted fractures of the radial head associated with elbow instability.
