Analysis of the predisposition factors for complications after artificial radial head replacement

Abstract

Objective To analyze the predisposition factors for cubitus valgus and other complications following radial head prosthesis replacement in treating comminuted fractures of the radial head. Methods From August 2008 to November 2011, 21 cases of radial head comminuted fractures were treated with prosthetic radial head replacement. There was one case with combined distal humeral fracture, 5 cases with combined olecranon fractures and 6 cases with combined elbow dislocation. Based on Mason classification, there were 15 type Ⅲ fractures and 6 type Ⅳ fractures. All were closed injuries that were surgically treated 2 weeks after the injury. Results Postoperatively 19 cases were follow-up while two cases were reportedly lost for follow-up. The follow-up period ranged from 5 to 79 months (mean 39.9 months). According to the Mayo elbow performance scoring system, the results were assessed as excellent in 16 cases, good in 2 cases and fair in 1 case. Out of the 19 cases, 4 cases had an elbow carrying angle more than 10° greater than that of the contralateral side. Seven cases had varying degrees of radiolucent area around the radius stem. There was no wound infection, nerve damage, metallic foreign body reaction, or wrist deformities. Elbow stiffness occurred in one case that required arthrolysis. There were 5 cases that had mild heterotopic ossification in the elbow, which did not significantly impair the movement of the elbow and forearm. Conclusion Prosthetic radial head replacement for treatment of radial head fractures lead to satisfactory intermediate term results. The most common complications are cubitus valgus and loosening of the prosthesis which may be attributed to surgical skills, the lack of filler or prosthesis strength. Key words: Radius; Fractures, bone; Radial head replacement; Complications