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Comparative study of radial head resection and prosthetic replacement in surgical release of stiff elbows

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Abstract

Purpose

Elbow trauma can compromise the arc of elbow flexion and forearm rotation. This study aimed at comparing the outcomes of radial head resection and prosthetic replacement in the surgical release of post traumatic elbow stiffness and associated restriction in forearm rotation.

Methods

We retrospectively reviewed the data of patients who underwent open arthrolysis with radial head resection (n = 15; resection group) or radial head replacement (n = 19; replacement group). The pre- and postoperative measurements of the elbow range of motion (ROM) were recorded. Elbow function was evaluated by the Broberg and Morrey Evaluation System; the Mayo Elbow Performance Index (MEPI); and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.

Results

Over a mean follow-up duration of 22 months, the improvement in the arc of flexion and extension was 79° (range, 45–125°) and 82° (range, 10–110°), while that in the ROM for forearm rotation was 96° (range, 40–150°) and 102° (range, 15–150°) in the resection and replacement groups, respectively. There were no significant intergroup differences in the elbow ROM measured at the last follow up. The Broberg and Morrey, MEPI, and Dash scores in the two groups were comparable.

Conclusions

Both resection and prosthetic replacement of the radial head with open arthrolysis of post traumatic elbow stiffness were feasible in treating the associated restriction of forearm rotation. We recommend that if the elbow is stable after complete release, radial head resection is preferable to prosthetic replacement because it is technically less demanding.

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Conflict of interest

None.

Ethical committee approval

The study protocol was approved by the ethical committee of Shanghai Jiao Tong University Affiliated Sixth People's Hospital East Campus with study number DYLL-2014004.

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Authors and Affiliations

  1. Department of Orthopaedics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China

    Shi-yang Yu, He-de Yan, Hong-jiang Ruan, Wei Wang & Cun-yi Fan

Authors
  1. Shi-yang Yu
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  2. He-de Yan
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  3. Hong-jiang Ruan
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  4. Wei Wang
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  5. Cun-yi Fan
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Corresponding author

Correspondence to Cun-yi Fan.

Additional information

Shi-yang Yu and He-de Yan contributed equally to this work.

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Yu, Sy., Yan, Hd., Ruan, Hj. et al. Comparative study of radial head resection and prosthetic replacement in surgical release of stiff elbows. International Orthopaedics (SICOT) 39, 73–79 (2015). https://doi.org/10.1007/s00264-014-2594-5

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  • DOI: https://doi.org/10.1007/s00264-014-2594-5

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