Abstract
Radial head fractures are the most common fracture of the elbow [1]. Undisplaced fractures or small (< 33% of radial head) minimally displaced fractures (< 2 mm) can be treated with early motion with an excellent outcome in the majority of patients [2, 3]. Small displaced fractures which cause painful crepitus or limited motion are managed with fragment excision if they are too small or osteopenic to be treated with open reduction and internal fixation (ORIF) [4–6]. Larger displaced fractures are typically managed with ORIF with good outcomes in most patients [7-11]. However, comminuted fractures that have three or more parts have faired poorly with ORIF [10]. These comminuted radial head fractures are generally treated with radial head excision, with or without radial head replacement. In the setting of an associated injury to the medial collateral, lateral collateral, or interosseous ligaments, radial head excision is contraindicated due to its important role as a valgus, varus and axial stabilizer [12–14].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
King GJ (2005) Fractures of the head of the radius. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe SW (eds), Green’s Operative Hand Surgery. Elsevier Churchill Livingstone, Philadelphia, pp 845–887
Holdsworth BJ, Clement DA, Rothwell PN (1987) Fractures of the radial head. The benefit of aspiration: a prospective controlled trial. Injury 18:44–47
Mason ML (1954) Some observations on fracture of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132
Wexner SD, Goodwin C, Parkes JC et al (1985) Treatment of fractures of the radial head by partial excision. Orthop Rev 14:83–86
Murray RC (1940) Fractures of the head and neck of the radius. Br J Surg 27:106–118
Castberg T, Thing E (1953) Treatment of fractures of the upper end of the radius. Acta Chir Scand 1051:62–69
Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: Late results in 26 cases. J Orthop Trauma 9:318–323
Geel CW, Palmer AK, Ruedi T, Leutenegger AF (1990) Internal fixation of proximal radial head fractures. J Orthop Trauma 4:270–274
King GJ, Evans DC, Kellam JF (1991) Open reduction and internal fixation of radial head fractures. J Orthop Trauma 5:21–28
Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815
Shmueli G, Herold HZ (1981) Compression screwing of displaced fractures of the head of the radius. J Bone Joint Surg Br 63:535–538
Roberts PH (1969) Dislocation of the elbow. Br J Surg 56:806–815
Adler JB, Shaftan GW (1962) Radial head fractures, is excision necessary? J Trauma 4:115–136
Johnston GW (1962) A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J 31:51–56
Josefsson PO, Johnell O, Wendeberg B (1987) Ligamentous injuries in dislocations of the elbowjoint. Clin Orthop Relat Res 221:221–225
Davidson PA, Moseley Jr JB, Tullos HS (1993) Radial head fracture. A potentially complex injury. Clin Orthop Relat Res 297:224–230
Sellman DC, Seitz Jr WH, Postak PD, Greenwald AS (1995) Reconstructive strategies for radioulnar dissociation: A biomechanical study. J Orthop Trauma 9:516–522
Pribyl CR, Rester MA, Cook SD et al (1986) The effect of the radial head excision and prosthetic radial head replacement on resisting valgus stress at the elbow. Orthopedics 9:723–726
King GJ, Zarzour ZD, Rath DA et al (1999) Metallic radial head arthroplasty improves valgus stability of the elbow. Clin Orthop Relat Res 368:114–125
Gordon M, Bullough PG (1982) Synovial and osseous inflammation in failed silicone-rubber prostheses: a report of six cases. J Bone Joint Surg Am 64:574–580
Martinelli B (1985) Silicone-implant replacement arthroplasty in fractures of the radial head. A follow-up report. Bull Hosp Jt Dis Orthop Inst 45:158–161
Mayhall WS, Tiley FT, Paluska DJ (1981) Fracture of silastic radial-head prosthesis. Case report. J Bone Joint Surg Am 63:459–460
Trepman E, Ewald FC (1991) Early failure of silicone radial head implants in the rheumatoid elbow. A complication of silicone radial head implant arthroplasty. J Arthroplasty 6:59–65
Vanderwilde RS, Morrey BF, Melberg MW, Vinh TN (1994) Inflammatory arthritis after failure of silicone rubber replacement of the radial head. J Bone Joint Surg Br 76:78–81
Edwards GE, Rostrup O (1960) Radial head prosthesis in the management of radial head fractures. Can J Surg 3:153–155
Harrington IJ, Sekyi-Otu A, Barrington TW et al (2001) The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: A long-term review. J Trauma 50:46–52
Harrington IJ, Tountas AA (1981) Replacement of the radial head in the treatment of unstable elbow fractures. Injury 12:405–412
Judet T, Garreau DL, Piriou P, Charnley G (1996) A floating prosthesis for radial-head fractures. J Bone Joint Surg Br 78:244–249
Knight DJ, Rymaszewski LA, Amis AA, Miller JH (1993) Primary replacement of the fractured radial head with a metal prosthesis. J Bone Joint Surg Br 75:572–576
Moro JK, Werier J, MacDermid JC et al (2001) Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 83:1201–1211
Popovic N, Gillet P, Rodriguez A, Lemaire R (2000) Fracture of the radial head with associated elbow dislocation: Results of treatment using a floating radial head prosthesis. J Orthop Trauma 14:171–177
Smets S, Govaers K, Jansen N et al (2000) The floating radial head prosthesis for comminuted radial head fractures: a multicentric study. Acta Orthop Belg 66:353–358
Gupta GG, Lucas G, Hahn DL (1997) Biomechanical and computer analysis of radial head prostheses. J Shoulder Elbow Surg 6:37–48
King GJ, Zarzour ZD, Patterson SD, Johnson JA (2001) An anthropometric study of the radial head: implications in the design of a prosthesis. J Arthroplasty 16:112–116
Beingessner DM, Dunning CE, Gordon KD et al (2004) The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am 86:1730–1739
Johnson JA, Beingessner DM, Gordon KD et al (2005) Kinematics and stability of the fractured and implant reconstructed radial head. J Shoulder Elbow Surg 14:S195–S201
Swanson AB, Jaeger SH, La Rochelle D (1981) Comminuted fractures of the radial head The role of silicone-implant replacement arthroplasty. J Bone Joint Surg Am 63:1039–1049
Carn RM, Medige J, Curtain D, Koenig A (1986) Silicone rubber replacement of the severely fractured radial head. Clin Orthop Relat Res 209:259–269
Beredjiklian PK, Nalbantoglu U, Potter HG, Hotchkiss RN (1999) Prosthetic radial head components and proximal radial morphology: a mismatch. J Shoulder Elbow Surg 8:471–475
O’Driscoll SW, Morrey BF, Korinek S, An KN (1992) Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res 280:186–197
Liew VS, Cooper IC, Ferreira LM et al (2003) The effect of metallic radial head arthroplasty on radiocapitellar joint contact area. Clin Biomech 18:115–118
Schneeberger A, Sadowski MM, Jacob HAC (2004) Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg Am 86:975–982
Dowdy PA, Bain GI, King GJ, Patterson SD (1995) The midline posterior elbow incision. An anatomical appraisal. J Bone Joint Surg Br 77:696–699
Van Glabbeek F, Van Rift R, Baumfeld J et al (2005) Detrimental effects of overstuffing or understuffing with a radial head replacement in the medial collateral ligament deficient elbow. J Bone Joint Surg Am 86:2629–2635
Birkedal JP, Deal DN, Ruch DS (2004) Loss of flexion after radial head replacement. J Shoulder and Elbow Surg 13:208–213
Armstrong AD, Dunning CE, Faber KJ et al (2000) Rehabilitation of the medial collateral ligament-deficient elbow: an in vitro biomechanical study. J Hand Surg Am 25:1051–1057
Dunning CE, Zarzour ZD, Patterson SD et al (2001) Muscle forces and pronation stabilize the lateral ligament deficient elbow. Clin Orthop Relat Res 388:118–124
Pugh DM, Wild LM, Schemitsch EH et al (2004) Standard surgical protocol to treat elbow dislocation with radial head and coronoid fractures. J Bone Joint Surg Am 86:1122–1130
McKee MD, Pugh DM, Wild LM et al (2005) Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Surgical technique. J Bone Joint Surg Am 87:22–32
Hildebrand KA, Patterson SD, King GJ (1999) Acute elbow dislocations: simple and complex. Orthop Clin North Am 30:63–79
Faber KJ, MacDermid JC, King GJW (2004) Modular metal radial head arthroplasty is an effective treatment for comminuted radial head fractures. Ninth Conference of the International Societies for Surgery of the Hand, Budapest Hungary (unpublished)
Parisien R, Doornberg J, Ring D (2005) Fracture-dislocations of the elbow: Replacement of the fractured radial head with a modular prosthesis. American Shoulder and Elbow Surgeons Annual Meeting, Washington DC (unpublished)
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag Italia
About this chapter
Cite this chapter
King, G.J.W. (2008). Evolve™ Modular Metallic Radial Head Arthroplasty. In: Treatment of Elbow Lesions. Springer, Milano. https://doi.org/10.1007/978-88-470-0591-4_16
Download citation
DOI: https://doi.org/10.1007/978-88-470-0591-4_16
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0317-0
Online ISBN: 978-88-470-0591-4
eBook Packages: MedicineMedicine (R0)