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Radial head replacement in adults with recent fractures

Bonnevialle, Nicolas Radial head replacement in adults with recent fractures. (2016) Orthopaedics & Traumatology: Surgery & Research, 102 (1 suppl). S69-S79. ISSN 1877-0568

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Official URL: https://doi.org/10.1016/j.otsr.2015.06.026

Abstract

Radial head fractures are fairly common (20% of all traumatic elbow injuries). Non-operative treatment is indicated in non-displaced fractures, and direct stable internal fixation allowing early elbow mobilisation in most other cases. For severely comminuted fractures precluding stable fixation, replacement of the radial head was introduced in the 1970s as a better alternative to simple radial head resection, which can induce instability of the elbow and/or forearm, most notably in patients who have complex fractures with concomitant lesions to other structures. With contemporary implants (modular or monoblock, with or without a mobile cup), mechanical stability is close to that provided by the native radial head, although appropriate treatment of concomitant lesions remains crucial (e.g., re-attachment of the radial collateral ligament, or distal radio-ulnar stabilisation in patients with Essex-Lopresti fracture). The key technical points are selection of implant size and determination of the optimal implantation height. The two most common complications are capitellar overloading due to excessively high implantation of the prosthetic head, which causes stiffness and pain, and loosening of the stem. These complications may require removal of the implant at a distance from the injury. Studies have demonstrated satisfactory clinical outcomes in 60% to 80% of cases.

Item Type:Article
Additional Information:Thanks to Elsevier editor. The definitive version is available at http://www.sciencedirect.com The original PDF of the article can be found at https://www.sciencedirect.com/science/article/pii/S187705681500314X
Audience (journal):International peer-reviewed journal
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Institution:Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
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Deposited By: Pascal SWIDER
Deposited On:08 Nov 2017 10:20

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