scholarly journals Retrospective Cohort Study on Radial Head Arthroplasty Comparing Long-Term Outcomes Between Valgus Type Injury and Fracture Dislocation

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution, lateral collateral ligament involvement and time from injury to RHA between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury. Methods A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of 9 years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups. Results In patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS. Conclusions With an average of 9 years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution, lateral collateral ligament involvement and time from injury to RHA between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution, lateral collateral ligament involvement and time from injury to RHA between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Chun-Jui Weng ◽  
Chih-Hao Chiu ◽  
Shih-Sheng Chang ◽  
Chun-Ying Cheng ◽  
...  
Keyword(s):  
Radial Head ◽  
Fracture Dislocation ◽  
Long Term Outcomes ◽  
Periprosthetic Osteolysis ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Injury Group ◽  
Motion Range

Abstract Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.

scholarly journals Long-Term Outcomes of Radial Head Arthroplasty in Complex Elbow Fracture Dislocation

2021 ◽  
Vol 10 (16) ◽  
pp. 3488
Author(s):  
Alvin Chao-Yu Chen ◽  
You-Hung Cheng ◽  
Chih-Hao Chiu ◽  
Chun-Ying Cheng ◽  
Yi-Sheng Chan
Keyword(s):  
Radial Head ◽  
Pearson Correlation ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Periprosthetic Osteolysis ◽  
Radial Head Arthroplasty ◽  
The Difference ◽  
Elbow Fracture Dislocation

The purpose of the current study was to investigate the long-term outcomes of radial head arthroplasty in complex elbow injuries through radiographic analysis and functional correlation. We evaluated 24 radial head arthroplasties in 24 consecutive patients with complex elbow fracture dislocation. All patients were treated with a single type of modular monopolar prosthesis containing smooth stem in press-fit implantation. Clinical survey using the Mayo Elbow Performance Score (MEPS), self-reported scales of shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the visual analog scale (VAS) at more than 10-year follow-up were reported and compared to 2-year outcomes. Periprosthetic osteolysis was measured in the 10 zones of prosthesis-cortical interface with a modified radiolucency score, which was calibrated by each prosthesis size. Pearson correlation analysis was performed to detect the association between periprosthetic radiolucency and clinical assessment. At the final follow-up, MEPS, QuickDASH score and VAS score averaged 82.5 ± 15, 14.1 ± 14.3 and 1.6 ± 1.2 respectively. A decline in functional status was noted, with decreased mean MEPS and increased mean QuickDASH and VAS scores as compared to the 2-year results while the difference was insignificant. Periprosthetic osteolysis was more prevalent around stem tip of zone 3 and zone 8. The final and 2-year radiolucency scores averaged 7.4 ± 4.2 and 2.6 ± 2.3 respectively with significant difference. Pearson correlation analysis indicated that the difference between radiolucency scores and clinical outcomes in MEPS/QuickDASH/VAS was −0.836, 0.517 and 0.464. Progression of periprosthetic osteolysis after postoperative 10 years is more prevalent around the stem tip with moderate to high correlation to clinical outcomes. Sustained follow-up is warranted to justify subsequent surgery for revision or implant removal.

scholarly journals 169 Clinical Outcomes of Radial Head Arthroplasty as Primary Treatment for Post-traumatic Mason Type 3 and 4 Fractures: A Long-term Follow-up

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Aslam ◽  
K Pearson ◽  
M Waseem
Keyword(s):  
Clinical Outcomes ◽  
Radial Head ◽  
Primary Treatment ◽  
Functional Restoration ◽  
Dash Score ◽  
Range Of Movement ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty

Abstract Aim Radial head arthroplasty (RHA) is the favoured treatment for complex radial head fractures, enabling functional restoration of elbow kinematics. However, study of long-term outcomes associated with RHA is largely neglected. This study aimed to fill the gap in the literature by firstly, assessing functional outcomes, and secondly, determining complications and rates of revision and/or removal of prosthesis associated with RHA, at our district general hospital. Method We retrospectively reviewed a consecutive single-surgeon series of patients receiving RHA as primary treatment for radial head fractures graded either 3 or 4 according to the Mason-Johnston classification between 2004 and 2009. Function at final follow-up was assessed using Quick Disabilities of the Arm, Shoulder and Hand (q-DASH) score and Mayo Elbow Performance Score (MEPS). Results 16 patients identified; 12 available for final follow-up. Mean follow-up time of 12.60 years (range: 10.67-16.08). Mean q-DASH score of 8.2 (range: 0-34.1). Mean MEPS of 85.83 (range: 50-100) with 11 (91.67%) reporting excellent/good results. All complications occurred within the first year post-operatively. Stiffness was the most common (50%) complication, but additional procedures improved objective range of movement in affected patients. Only one patient required implant revision throughout follow-up, which was due to prosthesis subluxation in the first month. Conclusions This study is amongst the first to examine clinical outcomes associated with RHA with an average follow-up >12 years. Our results emphasise good functional restoration and low implant failure rate. Regular follow-up particularly in the early post-operative period is essential in detecting and resolving complications.

scholarly journals BILATERAL TERRIBLE TRIAD INJURY OF THE ELBOW – A CASE REPORT

2020 ◽  
Vol 1 (1) ◽  
pp. 15-19
Author(s):  
Gabriela Soare ◽  
Cosmin Constantin Baciu ◽  
Gheorghe Ion Popescu ◽  
Laura Dragomirescu ◽  
Andrei Vișoianu
Keyword(s):  
Radial Head ◽  
Treatment Options ◽  
Fracture Dislocation ◽  
Terrible Triad ◽  
Radial Head Fractures ◽  
Posterior Displacement ◽  
Special Case ◽  
High Instability

Considered to be a rare and very disabling condition, bilateral terrible triad of the elbow is a fracture-dislocation, which consists in a fracture of the radial head and also of the coronoid process of the ulna, all of this associated with a posterior displacement of the elbow and high instability. It was named "terrible triad" because of the poor outcome of bone healing and range of motion, both medium and long term. What we present is a special case, first because it was not a unilateral terrible triad injury but bilateral, and because the treatment was different for each elbow, which was interesting for comparing the outcome. Although both radial head fractures were comminuted, with different treatment options, for one of them open reduction and internal fixation was performed, while for the other one our option was replacement of radial head with a prosthesis. For both elbows we obtained good functional outcome at 1-year follow up.

Complications, Reoperations, and Long-Term Outcomes after Open Reduction Internal Fixation of Mason Classification Type II and Type III Radial Head Fractures

2021 ◽  
Author(s):  
Dafang Zhang ◽  
George S. M. Dyer ◽  
Brandon E. Earp ◽  
Philip Blazar
Keyword(s):  
Radial Head ◽  
Open Reduction Internal Fixation ◽  
Type Ii ◽  
Long Term Outcomes ◽  
Radial Head Fractures ◽  
Mason Classification ◽  
Average Patient ◽  
Classification Type

Abstract Introduction The objectives of this study were to assess long-term outcomes, complications, and reoperations after open reduction internal fixation (ORIF) of radial head fractures. Materials and Methods 35 adult patients, who underwent ORIF of an isolated, displaced radial head fracture without elbow instability (Mason classification type II or III) at two tertiary care referral centers from 2000 to 2017, were identified. Patient satisfaction, pain, and QuickDASH scores were assessed by telephone follow-up at median 12.9 years. Results The mean age of the 35 patients in our study was 39 years, and 54% were women. The median length of clinical follow-up was 175 days. Postoperative complications occurred in 54% of patients, and reoperations in 23% of patients. Multivariable logistic regression identified fixation with plate and screws versus screws alone as a risk factor for complications and reoperations. The long-term telephone follow-up response rate was 54%. At 13-year median follow-up, the average patient satisfaction was 9.6/10, the average patient-reported pain was 0.7/10, and the average QuickDASH score was 10.5. Conclusion The long-term outcomes of ORIF of Mason classification type II and III radial head fractures are favorable; however, rates of complication and reoperation are notable and may be higher with plate-and-screw fixation.

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