scholarly journals Radial head resection versus replacement for unreconstructable radial head fractures

2020 ◽  
Vol 23 (3) ◽  
pp. 117-118
Author(s):  
Beom-Soo Kim ◽  
Chul-Hyun Cho
Keyword(s):  
Radial Head ◽  
Radial Head Fractures ◽  
Radial Head Resection

scholarly journals Radial head fractures

2019 ◽  
Vol 12 (3) ◽  
pp. 212-223 ◽  
Author(s):  
RP van Riet ◽  
MPJ van den Bekerom ◽  
A Van Tongel ◽  
C Spross ◽  
R Barco ◽  
...  
Keyword(s):  
Radial Head ◽  
Long Term Results ◽  
Valgus Stress ◽  
Proximal Ulna ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Radial Head Replacement ◽  
Treatment Type ◽  
Radial Head Resection ◽  
Type 3

The shape and size of the radial head is highly variable but correlates to the contralateral side. The radial head is a secondary stabilizer to valgus stress and provides lateral stability. The modified Mason–Hotchkiss classification is the most commonly used and describes three types, depending on the number of fragments and their displacement. Type 1 fractures are typically treated conservatively. Surgical reduction and fixation are recommended for type 2 fractures, if there is a mechanical block to motion. This can be done arthroscopically or open. Controversy exists for two-part fractures with >2 mm and <5 mm displacement, without a mechanical bloc as good results have been published with conservative treatment. Type 3 fractures are often treated with radial head replacement. Although radial head resection is also an option as long-term results have been shown to be favourable. Radial head arthroplasty is recommended in type 3 fractures with ligamentous injury or proximal ulna fractures. Failure of primary radial head replacement may be due to several factors. Identification of the cause of failure is essential. Failed radial head arthroplasty can be treated by implant removal alone, interposition arthroplasty, revision radial head replacement either as a single stage or two-stage procedure.

scholarly journals Radial Head Resection versus Arthroplasty in Unrepairable Comminuted Fractures Mason Type III and Type IV: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Francesco Catellani ◽  
Francesca De Caro ◽  
Carlo F. De Biase ◽  
Vincenzo R. Perrino ◽  
Luca Usai ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Radial Head ◽  
Stability Range ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Type Iii ◽  
Type Iv ◽  
Radial Head Resection ◽  
Comminuted Fractures ◽  
Poor Outcomes

Unrepairable comminuted fractures of the radial head Mason type III or type IV have poor outcomes when treated by open reduction and internal fixation. Radial head resection has been proposed as good option for surgical treatment, while in the last decades, the development of technology and design in radial head prosthesis has increased efficacy in prosthetic replacement. The present review was conducted to determine the best surgical treatment for comminuted radial head when ORIF is not possible. Better outcomes are reported for radial head arthroplasty in terms of elbow stability, range of motion, pain, and fewer complications compared to radial head excision. Nevertheless, radial head resection still can be considered an option of treatment in isolated radial head fractures with no associated ligament injuries lesion of ligaments or in case of older patients with low demanding function.

Is radial head resection the first choice treatment of comminuted radial head fractures without associated instability?

Injury ◽  
2017 ◽  
Vol 48 (2) ◽  
pp. 560-562 ◽  
Author(s):  
Nick F.J. Hilgersom ◽  
Denise Eygendaal ◽  
Michel P.J. van den Bekerom
Keyword(s):  
Radial Head ◽  
Radial Head Fractures ◽  
First Choice ◽  
Radial Head Resection

scholarly journals Is radial head resection a menace for the clinical outcomes of the elbow for comminuted radial head fractures?

2018 ◽  
Vol 5 (1) ◽  
pp. 70
Author(s):  
B. Mohan Choudhary ◽  
S. Pradeesh Kiswanth ◽  
R. Dorai Kumar
Keyword(s):  
Clinical Outcomes ◽  
Radial Head ◽  
Indian Population ◽  
Clinical Results ◽  
Performance Score ◽  
Radial Head Fractures ◽  
Mayo Elbow Performance Score ◽  
Elbow Fractures ◽  
Radial Head Resection ◽  
Excellent Functional Outcome

<p class="abstract"><strong>Background:</strong> Radial head fractures are about 20% of all the elbow fractures. Comminuted radial head fractures can cause great impairment on upper extremity functional status. In older times, radial head resection was the treatment of choice for comminuted radial head fractures. Recently, radial head implant arthroplasty has become popular for fractures that could not be fixed. In this study, we assess the clinical outcomes in patients who underwent Radial head resection in Indian population of the productive age group.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 15 patients of age more than 18 and less than 50 years of age, who have underwent radial head resection for Mason type III radial head fractures. Outcomes were evaluated according to the Mayo Elbow Performance Score at 3 months, 6 months and at 1 year follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> We observed that 80% of our patients were pain free at the end of 1 year and 20% had minimal to moderate pain. About 80% of our patients regained their “functional range” of movements. 12 of our patients had a stable elbow joint and only 3 patients complained of minimal to moderate instability after the procedure. 87% of our patients had a good to excellent functional outcome at the end. The mean Mayo elbow performance score was 92.3 which is graded as excellent and did not have any significant complications to hinder the clinical outcome.</p><p class="abstract"><strong>Conclusions:</strong> Radial head resection yields a good to excellent clinical results in young Indian population with isolated comminuted radial head fractures.</p>

Long-Term Results of Radial Head Resection Following Isolated Radial Head Fractures in Patients Younger Than Forty Years Old

2010 ◽  
Vol 92 (3) ◽  
pp. 558-566 ◽  
Author(s):  
Samuel A Antuña ◽  
José M Sánchez-Márquez ◽  
Raúl Barco
Keyword(s):  
Radial Head ◽  
Long Term Results ◽  
Radial Head Fractures ◽  
Radial Head Resection

Polylactide pins can effectively fix severely comminuted and unsalvageable radial head fracture: a retrospective study of 40 patients

2020 ◽  
Author(s):  
Liang Guo ◽  
睿夫 li ◽  
Xuhui Yang ◽  
Chao Yu ◽  
Fei Gui
Keyword(s):  
Internal Fixation ◽  
Radial Head ◽  
Open Reduction ◽  
Radial Head Fracture ◽  
Treatment Plan ◽  
Young Patients ◽  
Radial Head Fractures ◽  
Mayo Elbow Performance Score ◽  
Metallic Implants ◽  
Radial Head Resection

Abstract Background The treatment of comminuted unsalvageable radial head fracture remains controversial. Open reduction and internal fixation are hard to achieve. Common techniques include radial head resection and arthroplasty. Both methods have characteristic complications. The present study aims to demonstrate the feasibility of treating unreducible radial head fractures with absorbable polylactide pins. Methods A total of 17 patients with severely comminuted Mason type III radial head fractures were treated with open reduction and internal fixation using polylactide pins and 23 with metallic implants. Patients receiving both modalities were followed-up for a mean of 15 months (standard deviation [SD]: 2.6). Radiographic analysis was conducted 2, 30, 60 and 120 days after surgery. Measurements of range of motion (ROM), disability of arm shoulder and hands, Mayo elbow performance score and Broberg and Morrey elbow score were recorded, with treatments compared using a Mann-Whitney U test. Result All fractures healed successfully. The data shows no statistical difference between the polylactide and metallic implant groups. Complications were infrequent and did not cause disability. All patients were satisfied with the surgical outcomes. Conclusion Polylactide pins can feasibly treat severely comminuted radial head fractures which are normally considered unreducible. The outcomes were similar to those of metallic implants. This technique provides an optional treatment plan in addition to resection and arthroplasty, especially for young patients that refuse that form of treatment.

Acute Radial Head Resection for Fracture: are We Likely to Miss an Essex-Lopresti Injury?

2021 ◽  
Vol 23 (4) ◽  
pp. 263-270
Author(s):  
Dafang Zhang ◽  
Kyra A. Benavent ◽  
George S. M. Dyer ◽  
Brandon E. Earp ◽  
Philip Blazar
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Radial Head Fractures ◽  
Pain Scores ◽  
Radial Head Resection ◽  
Forearm Instability ◽  
Level I ◽  
Pull Tests ◽  
Essex Lopresti

Background. Given the current available evidence, surgical treatment of radial head fracture with acute resection is controversial. The aim of this study was to determine whether acute resection of the radial head for a radial head fracture leads to longitudinal forearm instability due to a missed Essex-Lopresti injury. Material and methods. A retrospective review was conducted of radial head resections performed for acute radial head fractures at two Level I trauma centers from 2000 to 2018. A total of 11 patients met inclusion criteria. Our primary outcome was a missed Essex-Lopresti injury at time of final clinical follow-up. Long-term telephone follow-up was attempted for QuickDASH, pain scores, and satisfaction scores. Results. Of the 11 radial head fractures in this study, intraoperative radial pull tests were performed and normal in 6 patients. No patient was found to have a missed Essex-Lopresti injury at a mean of 36.2 months’ clinical follow-up after radial head resection. At a mean telephone follow-up of 12.6 years in available patients, mean QuickDASH was 3.4, mean satisfaction was 9.75 out of 10, and no further complication or reoperation was reported. Conclusion. Our findings challenge the dogma that the radial head cannot be safely excised in the setting of acute fracture, even with elbow instability and/or wrist pain, particularly when intraoperative longitudinal stability is assessed by a stress maneuver.

Radial Head Fractures

2021 ◽  
pp. 505-508
Author(s):  
James D. Spearman ◽  
David Ring ◽  
Lee M. Reichel
Keyword(s):  
Radial Head ◽  
Radial Head Fractures
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