What happens to the elbow joint after fractured radial head excision? Clinical and radiographic study at a mean 15-yearfollow-up

Background Radial head excision has historically been a common surgical procedure for the operative management of radial head fractures and post-traumatic conditions. With recent advances in other surgical techniques, controversy exists regarding its indications. This review evaluates the indications and outcomes of radial head excision in traumatic and non-traumatic elbow pathology. Methods Multiple databases were searched for studies involving radial head excision. Screening and data abstraction were conducted in duplicate. Only studies reporting outcomes for radial head excision were included. Results Twenty-seven studies with 774 radial head excision patients were included. The most common indications involved acute excision of comminuted radial head fractures (n = 347) and rheumatoid arthritis (n = 201). Post-operative functional scores after acute excision were reported to be good to excellent. In the chronic setting of rheumatoid disease, radial head excision resulted in improved range of motion, although pain was not effectively relieved. Discussion Outcomes of radial head excision for acute fracture are good to excellent; however, it should not be performed when concurrent or ligamentous injuries are present. Although some studies compared excision to open reduction and internal fixation or replacement, more data are needed to make proper conclusions. The strength of these conclusions is limited by the quality of included literature.

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Accuracy and Precision of a Control System for an Elbow Joint Simulator

ASME 2008 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2008-192826 ◽

2008 ◽

Author(s):

Patrick J. Schimoler ◽

Jeffrey S. Vipperman ◽

Laurel Kuxhaus ◽

Daniel D. Budny ◽

Angela M. Flamm ◽

...

Keyword(s):

Control System ◽

Soft Tissue ◽

Radial Head ◽

Elbow Joint ◽

Joint Motion ◽

Joint Mechanics ◽

Scientific Investigations ◽

Accuracy And Precision ◽

Control Schemes ◽

Joint Implants

Joint motion simulators (JMS’s) have been developed for many applications enabling the repeatable testing of prostheses, scientific investigations of joint mechanics and the study of surgical procedures.[1–4] Although Morrey has reported that radial head implants have lower post-operative satisfaction than other joint implants[5] and Dunning has examined several issues with radial heads, many problems remain.[6] It is therefore beneficial to develop a simulator capable of evaluating radial head implants. A robust simulator can also provide the ability to test soft tissue strains at the elbow and compare control schemes that may elucidate the body’s means of controlling multiaxial multimuscle systems.

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Management of the failed radial head arthroplasty

EFORT Open Reviews ◽

10.1302/2058-5241.5.190055 ◽

2020 ◽

Vol 5 (7) ◽

pp. 398-407

Author(s):

Izaäk F. Kodde ◽

Jetske Viveen ◽

Bertram The ◽

Roger P. van Riet ◽

Denise Eygendaal

Keyword(s):

Radial Head ◽

Elbow Joint ◽

Absolute Number ◽

Radial Head Arthroplasty ◽

Current Article ◽

The Absolute ◽

Work Up

Primary radial head arthroplasty (RHA) produces good or excellent results in approximately 85% of patients. However, complications are not uncommon and have been described in up to 23% of cases. The number of RHA is increasing, and consequently the absolute number of complications is expected to rise as well. The decision on whether to revise or remove the prosthesis seems more likely to depend on the preference of the surgeon or the hospital, rather than on objectifying problems with the prosthesis. The current article presents an algorithm for the work-up and treatment of most complications that can occur following RHA. Five subgroups of problems were identified: osteoarthritis, stiffness, instability, infection and implant-related issues. In short, the preferred treatment depends mainly on the chondral condition and stability of the elbow joint. Cite this article: EFORT Open Rev 2020;5:398-407. DOI: 10.1302/2058-5241.5.190055

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SYNOVECTOMY OF THE ELBOW AND RADIAL HEAD EXCISION IN RHEUMATOID ARTHRITIS

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.79b6.0790918 ◽

1997 ◽

Vol 79-B (6) ◽

pp. 918-923 ◽

Cited By ~ 13

Author(s):

N. S. T. Gendi ◽

J. M. C. Axon ◽

A. J. Carr ◽

K. D. Pile ◽

P. D. Burge ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Radial Head ◽

Radial Head Excision

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Arthroscopic elbow joint release with radial head resection arthroplasty: 12 cases

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2015.07.009 ◽

2015 ◽

Vol 101 (6) ◽

pp. 735-739 ◽

Cited By ~ 10

Author(s):

B. Chedal Bornu ◽

X. Clément ◽

J.F. Kempf ◽

P. Clavert

Keyword(s):

Radial Head ◽

Elbow Joint ◽

Resection Arthroplasty ◽

Radial Head Resection

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Radial Neck Osteotomy for Malunion of Radial Neck Fracture in Childhood

Case Reports in Orthopedics ◽

10.1155/2015/871429 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Simon Vandergugten ◽

Serge Troussel ◽

Bernard Lefebvre

Keyword(s):

Avascular Necrosis ◽

Radial Head ◽

Elbow Joint ◽

Open Reduction ◽

Articular Surface ◽

Coronoid Process ◽

Radial Neck Fracture ◽

Radial Neck ◽

Neck Fracture ◽

Initial Fracture

In a case of a neglected radial neck fracture in childhood, the management of initial fracture and its complications are subjected to discussion. In children, open reduction should be avoided but an angulation less than 30° must be obtained. Several techniques exist to manage symptomatic malunion in adults, including resection, prosthesis, and osteotomy. When performing an osteotomy, it is important first to preserve an intact osseous hinge to avoid avascular necrosis and second to align the edge of the radial head articular surface with the lateral edge of the coronoid process, in order to avoid overstuffing elbow joint.

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