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2016, Number 2

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Revista Cubana de Ortopedia y Traumatología 2016; 30 (2)

Pyrolytic carbon prosthesis in the comminuted fractures of the radius head

Angulo TM, Martínez VG, Hidalgo MB

Language: Spanish
References: 32
Page: 183-192
PDF size: 248.15 Kb.


ABSTRACT

Comminuted radial head fractures are difficult to reconstruct and often lead to total resection. They may result in longitudinal or lateral instability of the forearm and neurological damage. Prosthetic surgery is a useful therapeutic alternative in preventing these problems. We present the results of pyrolytic carbon prosthesis (Mopyc®) for comminuted radial head fractures in 10 patients, with mean postoperative follow-up of 5.7 years. The mean range of motion was 124,3° for elbow flexion, with extension deficit of 23,7°, supination was 74,7°, and pronation 79.5°. Grip strength loss was 46.09 % of the unaffected hand. The average postoperative Q-DASH was 24.6, with residual pain of 2.6 on the visual analogue scale. Two complications were recorded. The level of patient satisfaction was high.


REFERENCES

  1. Vichard P, Tropet Y, Dreyfus-Schmidt G, Besancenot J, Menez D, Pem R. Fractures of the proximal end of the radius associated with other traumatic lesions of the upper limb. A report of seventy-three cases. Ann Chir Main Organe Off Sociétés Chir Main. 1988;7(1):45-53.

  2. Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-7.

  3. Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM. The epidemiology of radial head and neck fractures. J Hand Surg. 2012;37(1):112-9.

  4. Kuntz DG Jr, Baratz ME. Fractures of the elbow. Orthop Clin North Am. 1999;30(1):37-61.

  5. Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop. 1987;(216):109-19.

  6. Morrey BF, An KN, Stormont TJ. Force transmission through the radial head. J Bone Joint Surg Am. 1988;70(2):250-6.

  7. Hotchkiss RN, Weiland AJ. Valgus stability of the elbow. J Orthop Res Off Publ Orthop Res Soc. 1987;5(3):372-7.

  8. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop. 1991;(265):187-95.

  9. Jensen SL, Deutch SR, Olsen BS, Søjbjerg JO, Sneppen O. Laxity of the elbow after experimental excision of the radial head and division of the medial collateral ligament. Efficacy of ligament repair and radial head prosthetic replacement: a cadaver study. J Bone Joint Surg Br. 2003;85(7):1006-10.

  10. Shepard MF, Markolf KL, Dunbar AM. Effects of radial head excision and distal radial shortening on load-sharing in cadaver forearms. J Bone Joint Surg Am. 2001;83-A(1):92-100.

  11. Tejwani SG, Markolf KL, Benhaim P. Reconstruction of the interosseous membrane of the forearm with a graft substitute: a cadaveric study. J Hand Surg. 2005;30(2):326-34.

  12. Schneeberger AG, Sadowski MM, Jacob HAC. Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg Am. 2004;86-A(5):975-82.

  13. Davidson PA, Moseley JB Jr, Tullos HS. Radial head fracture. A potentially complex injury. Clin Orthop. 1993;(297):224-30.

  14. Charalambous CP, Stanley JK, Mills SP, Hayton MJ, Hearnden A, Trail I, et al. Comminuted radial head fractures: aspects of current management. J Shoulder Elb Surg Am Shoulder Elb Surg Al. 2011;20(6):996-1007.

  15. Duckworth AD, McQueen MM, Ring D. Fractures of the radial head. Bone Jt J. 2013;95-B(2):151-9.

  16. Ashwood N, Bain GI, Unni R. Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. J Bone Joint Surg Am. 2004;86-A(2):274-80.

  17. Patterson SD, Bain GI, Mehta JA. Surgical approaches to the elbow. Clin Orthop. 2000;(370):19-33.

  18. Itamura J, Roidis N, Mirzayan R, Vaishnav S, Learch T, Shean C. Radial head fractures: MRI evaluation of associated injuries. J Shoulder Elb Surg Am Shoulder Elb Surg Al. 2005;14(4):421-4.

  19. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123-32.

  20. Kovar FM, Jaindl M, Thalhammer G, Rupert S, Platzer P, Endler G, et al. Incidence and analysis of radial head and neck fractures. World J Orthop. 2013;4(2):80-4.

  21. Kaas L, van Riet RP, Vroemen JPAM, Eygendaal D. The incidence of associated fractures of the upper limb in fractures of the radial head. Strateg Trauma Limb Reconstr Online. 2008;3(2):71-4.

  22. van Riet RP, Morrey BF, O'Driscoll SW, Van Glabbeek F. Associated injuries complicating radial head fractures: a demographic study. Clin Orthop. 2005;441:351-5.

  23. Burkhart KJ, Mattyasovszky SG, Runkel M, Schwarz C, Küchle R, Hessmann MH, et al. Mid-to long-term results after bipolar radial head arthroplasty. J Shoulder Elb Surg Am Shoulder Elb Surg Al. 2010;19(7):965-72.

  24. Doornberg JN, Parisien R, van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am. 2007;89(5):1075-80.

  25. Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83-A(8):1201-11.

  26. Lamas C, Castellanos J, Proubasta I, Dominguez E. Comminuted radial head fractures treated with pyrocarbon prosthetic replacement. Hand N Y N. 2011;6(1):27-33.

  27. Sarris IK, Kyrkos MJ, Galanis NN, Papavasiliou KA, Sayegh FE, Kapetanos GA. Radial head replacement with the MoPyC pyrocarbon prosthesis. J Shoulder Elb Surg Am Shoulder Elb Surg Al. 2012;21(9):1222-8.

  28. Müller MC, Burger C, Wirtz DC, Weber O. Replacement of the comminuted radial head fracture by a bipolar radial head prosthesis. Oper Orthop Traumatol. 2011;23(1):37-45.

  29. Harrington IJ, Sekyi-Otu A, Barrington TW, Evans DC, Tuli V. The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review. J Trauma. 2001;50(1):46-52.

  30. Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJW. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am. 2004;86-A(8):1730-9.

  31. Pugh DMW, Wild LM, Schemitsch EH, King GJW, McKee MD. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Am. 2004;86-A(6):1122-30.

  32. Shin R, Ring D. The ulnar nerve in elbow trauma. J Bone Joint Surg Am. 2007;89(5):1108-16.




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