Anatomic radial head prosthesis replacement for comminuted radial head fractures

GUO Yong-zhi; PENG Cheng; LI Lian-hua; LI Shao-guang; ZHAO Jian-wen; HE Hong-ying; DAI He-ling; LIU Zhi

doi:10.3969/j.issn.2095-252X.2014.03.006

Abstract：Objective To explore the early clinical results of anatomic radial head prosthesis replacement in the treatment of comminuted radial head fractures. Methods From June 2009 to May 2013, a total of 21 patients underwent Acumed anatomic radial head prosthesis replacement for comminuted radial head fractures, including 15 men and 6 women, whose mean age was 32.5 years old ( range;29-52 years ). There were 8 cases on the left side and 13 cases on the right side. All were fresh closed fractures. According to the Mason classiifcation, there were 8 cases of type III, 6 cases of type IV, 3 cases of terrible triad injury of the elbow, 2 cases of Essex-Lopresti injury and 2 cases of posterior olecranon fracture-dislocation of Monteggia type II. The operation was performed at 6.8 days after the injury on average ( range;3-14 days ). Results All the patients were followed up for an average period of 18.75 months ( range;6-38 months ). No incision infection, radial nerve injury, prosthetic loosening, elbow instability or traumatic osteoarthritis was found. There were 2 cases of mild pain in the elbow joint. Heterotopic ossiifcation was found in 5 cases, but no distinct limitation of locomotion of the elbow and forearm was noticed. According to the Broberg and Morrey rating system, the results showed 10 excellent cases, 8 good, 2 fair, and 1 poor. The excellent and good rate was 85.7%. Conclusions Acumed anatomic radial head prosthesis replacement is an effective method in the treatment of comminuted radial head fractures, which can better restore the stability, lfexion and extension of the elbow and the rotational motion of the forearm, with satisfactory clinical results.