Abstract
BackgroundRadial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.MethodsA retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of 9 years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.ResultsIn patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.ConclusionsWith an average of 9 years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.
Highlights
Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury
Better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation
Chen et al BMC Musculoskeletal Disorders (2020) 21:763. Given that it has long been debated about rationales of prosthesis replacement in the elbow fractures involving radial head [1], radial head arthroplasty (RHA) is generally considered a feasible alternative to radial head resection for irreparable radial head fractures [2]
Summary
Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury. Given that it has long been debated about rationales of prosthesis replacement in the elbow fractures involving radial head [1], radial head arthroplasty (RHA) is generally considered a feasible alternative to radial head resection for irreparable radial head fractures [2]. RHA in traumatic valgus instability has less been fully addressed This led us to perform a retrospective, case-control study, and hypothesize that RHA in valgus type injuries yielded different functional and radiographic outcomes. The secondary aim is to compare the clinical and radiological differences of RHA between valgus type injury and fracture dislocation type injury
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