The Short Term Results of Radial Head Arthroplasty with Unipolar Loose Fit Stem

Su-Keon Lee; Kyeong-Seop Song; Seung-Hwan Lee; Sang-Pil Yoon; Sang-Youn Lim

doi:10.12671/jkfs.2015.28.2.125

Journal List > J Korean Fract Soc > v.28(2) > 1038021

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Lee, Song, Lee, Yoon, and Lim: The Short Term Results of Radial Head Arthroplasty with Unipolar Loose Fit Stem

Original Article

Journal of the Korean Fracture Society 2015; 28(2): 125-131.

Published online: 21 April 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.2.125

The Short Term Results of Radial Head Arthroplasty with Unipolar Loose Fit Stem

Su-Keon Lee, M.D., Kyeong-Seop Song, M.D., Seung-Hwan Lee, M.D., Sang-Pil Yoon, M.D., Sang-Youn Lim, M.D.

Department of Orthopedic Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

Address reprint requests to: Kyeong-Seop Song, M.D. Department of Orthopedic Surgery, Gwangmyeong Sungae Hospital, 36 Digital-ro, Gwangmyeong 423-711, Korea. Tel: 82-2-268-7236, Fax: 82-2-2680-7252, limsy2003@naver.com

Received 9 July 2014 Revised 26 November 2014 Accepted 18 March 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report short-term results of radial head prosthesis using a unipolar loose fit stem in ten patients.

Materials and Methods

Ten patients with Mason type three radial head fracture, who received unipolar radial head arthroplasty from February 2010 to June 2011, were evaluated (mean follow-up: 22 months, range: 18-30 months). Subjects consisted of five men and five women. Range of elbow motion was measured. Mayo elbow performance index (MEPI) score was used for functional evaluation and periodic radiological imaging was performed to evaluate the stability of implant.

Results

After an average follow-up of 22 months, elbow stability was maintained in all cases, and the average range of motion of elbow flexion and extension was 6 to 130 degrees. Average range of pronation and supination was 66 and 74 degrees, respectively. MEPI score was evaluated as excellent in seven cases, and good in three cases. On final follow-up, radiological assessment showed implant stability in all cases without evidence of dislocation, subluxation, arthritis, periprosthetic osteolysis or heterotopic ossification.

Conclusion

Based on our short-term follow-up, radial head arthroplasty with unipolar loose fit stem is a useful method for obtaining satisfactory outcome for unreducible comminuted radial head fractures.

Keywords: Elbow, Radial head fracture, Unipolar radial head arthroplasty, Loose fit stem

Figures and Tables

Fig. 1

Preoperative antero-posterior (A) and lateral (B) radiographs show a serious triad injury. At 12 months after the operation, antero-posterior (C) and lateral (D) radiographs of the elbow show a well aligned ulnohumeral and radiocapitellar joint. Tension band wirings for fracture of ulnar olecranon was applied simultaneously.

Fig. 2

At 24 months after the operation, antero-posterior (A) and lateral (B) radiographs show osteolysis around the proximal radius and stem and a loose prosthesis from the cemented bipolar replacement group.

Table 1

Type of Radial Head Fracture with Associated Injuries of 10 Patients

LCL: Lateral collateral ligament.

Table 2

Range of Motion and MEPI Scores at Final Follow-Up

MEPI: Mayo elbow performance index.

Notes

^{Financial support} None.

^{Conflict of interest} None.

References

1. Morrey B. The elbow and its disorders. 3rd ed. Philadelphia: WB Saunders Co;2000. p. 341–364.

2. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954; 42:123–132.

3. Calfee R, Madom I, Weiss AP. Radial head arthroplasty. J Hand Surg Am. 2006; 31:314–321.

4. Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3-18 years. Acta Orthop Scand. 2000; 71:191–194.

5. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res. 1991; 265:187–195.

6. Vanderwilde RS, Morrey BF, Melberg MW, Vinh TN. Inflammatory arthritis after failure of silicone rubber replacement of the radial head. J Bone Joint Surg Br. 1994; 76:78–81.

7. Speed K. Ferrule caps for the head of the radius. Surg Gynecol Obset. 1941; 73:845–850.

8. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma. 2001; 50:46–52.

9. Knight DJ, Rymaszewski LA, Amis AA, Miller JH. Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br. 1993; 75:572–576.

10. King GJ, Zarzour ZD, Patterson SD, Johnson JA. An anthropometric study of the radial head: implications in the design of a prosthesis. J Arthroplasty. 2001; 16:112–116.

11. Judet T, Garreau de Loubresse C, Piriou P, Charnley G. A floating prosthesis for radial-head fractures. J Bone Joint Surg Br. 1996; 78:244–249.

12. Popovic N, Lemaire R, Georis P, Gillet P. Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface. J Bone Joint Surg Am. 2007; 89:2469–2476.

13. van Riet RP, Van Glabbeek F, Neale PG, Bortier H, An KN, O'Driscoll SW. The noncircular shape of the radial head. J Hand Surg Am. 2003; 28:972–978.

14. Kang HJ, Choi YW, Han SB, Kang ES. Mini-plate fixation for comminuted radial head fracture. J Korean Soc Surg Hand. 2003; 8:171–176.

15. King GJ, Evans DC, Kellam JF. Open reduction and internal fixation of radial head fractures. J Orthop Trauma. 1991; 5:21–28.

16. Sanders RA, French HG. Open reduction and internal fixation of comminuted radial head fractures. Am J Sports Med. 1986; 14:130–135.

17. Esser RD, Davis S, Taavao T. Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma. 1995; 9:318–323.

18. Morrey BF, Askew L, Chao EY. Silastic prosthetic replacement for the radial head. J Bone Joint Surg Am. 1981; 63:454–458.

19. Harrington IJ, Tountas AA. Replacement of the radial head in the treatment of unstable elbow fractures. Injury. 1981; 12:405–412.

20. Heim U. Combined fractures of the radius and the ulna at the elbow level in the adult. Analysis of 120 cases after more than 1 year. Rev Chir Orthop Reparatrice Appar Mot. 1998; 84:142–153.

21. Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am. 2002; 84:547–551.

22. Josefsson PO, Gentz CF, Johnell O, Wendeberg B. Dislocations of the elbow and intraarticular fractures. Clin Orthop Relat Res. 1989; 246:126–130.

23. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001; 83:1201–1211.

24. Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006; 88:2192–2200.

25. Pugh DM, Wild LM, Schemitsch EH, King GJ, McKee MD. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Am. 2004; 86:1122–1130.

26. Park JW, Moon JG, Park JH, et al. The short term results of bipolar radial head prosthesis. J Korean Soc Surg Hand. 2008; 13:188–194.

27. Herald J, O'Driscoll S. Complete dissociation of a bipolar radial head prosthesis: a case report. J Shoulder Elbow Surg. 2008; 17:e22–e23.

28. Moon JG, Berglund LJ, Zachary D, An KN, O'Driscoll SW. Radiocapitellar joint stability with bipolar versus monopolar radial head prostheses. J Shoulder Elbow Surg. 2009; 18:779–784.

29. O'Driscoll SW, Herald J. Symptomatic failure of snap-on bipolar radial head prosthesis. J Shoulder Elbow Surg. 2009; 18:e7–e11.

30. Yian E, Steens W, Lingenfelter E, Schneeberger AG. Malpositioning of radial head prostheses: an in vitro study. J Shoulder Elbow Surg. 2008; 17:663–670.

31. Doornberg JN, Parisien R, van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am. 2007; 89:1075–1080.

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