An anthropometric study of the radial head: implications in the design of a prosthesis.

The dimensions of the native radial head were measured in 28 cadaveric upper extremities and radiographs of the contralateral elbows of 40 patients who had received a radial head replacement. The mean difference between the maximum and minimum radial head diameters was 1.7 +/- 0.7 mm (range, 0.12-3.27 mm). This variability suggests that although the native radial head is not circular, it does not have a consistently elliptic shape. The native radial head also is variably offset from the axis of the neck (4.2 +/- 2.5 mm), suggesting that a radial head hemiarthroplasty that precisely replicates normal anatomy would be difficult to achieve. There was a poor correlation between the radial head diameter and the medullary canal of the radial neck, suggesting that a modular implant system should be considered.

[1]  Kai-Nan An,et al.  Articular and ligamentous contributions to the stability of the elbow joint , 1983, The American journal of sports medicine.

[2]  H. Tullos,et al.  Radial head fracture. A potentially complex injury. , 1993, Clinical orthopaedics and related research.

[3]  A. Weiland,et al.  Valgus stability of the elbow , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[4]  S. Cook,et al.  The effect of the radial head and prosthetic radial head replacement on resisting valgus stress at the elbow. , 1986, Orthopedics.

[5]  B. Morrey,et al.  Inflammatory arthritis after failure of silicone rubber replacement of the radial head. , 1994, The Journal of bone and joint surgery. British volume.

[6]  E. Trepman,et al.  Early failure of silicone radial head implants in the rheumatoid elbow. A complication of silicone radial head implant arthroplasty. , 1991, The Journal of arthroplasty.

[7]  P. Piriou,et al.  A floating prosthesis for radial-head fractures. , 1996, The Journal of bone and joint surgery. British volume.

[8]  Fracture of silastic radial-head prosthesis. Case report. , 1981, The Journal of bone and joint surgery. American volume.

[9]  V. M. Santoro,et al.  The nonarticulating portion of the radial head: anatomic and clinical correlations for internal fixation. , 1998, The Journal of hand surgery.

[10]  E. Chao,et al.  Biomechanical study of the elbow following excision of the radial head. , 1979, The Journal of bone and joint surgery. American volume.

[11]  E. Chao,et al.  Silastic prosthetic replacement for the radial head. , 1981, The Journal of bone and joint surgery. American volume.

[12]  James A. Johnson,et al.  Metallic radial head arthroplasty improves valgus stability of the elbow. , 1999, Clinical orthopaedics and related research.

[13]  B F Morrey,et al.  Valgus stability of the elbow. A definition of primary and secondary constraints. , 1991, Clinical orthopaedics and related research.

[14]  P. Beredjiklian,et al.  Prosthetic radial head components and proximal radial morphology: a mismatch. , 1999, Journal of shoulder and elbow surgery.

[15]  G. G. Gupta,et al.  Biomechanical and computer analysis of radial head prostheses. , 1997, Journal of shoulder and elbow surgery.

[16]  A. Swanson,et al.  Comminuted fractures of the radial head. The role of silicone-implant replacement arthroplasty. , 1981, The Journal of bone and joint surgery. American volume.

[17]  I. Harrington,et al.  Replacement of the radial head in the treatment of unstable elbow fractures. , 1981, Injury.

[18]  A. Greenwald,et al.  Reconstructive Strategies for Radioulnar Dissociation: A Biomechanical Study , 1995, Journal of orthopaedic trauma.

[19]  D. Stoffelen,et al.  Excision or Silastic replacement for comminuted radial head fractures. A long-term follow-up. , 1994, Acta orthopaedica Belgica.

[20]  J. Medige,et al.  Silicone rubber replacement of the severely fractured radial head. , 1986, Clinical orthopaedics and related research.

[21]  A A Amis,et al.  Primary replacement of the fractured radial head with a metal prosthesis. , 1993, The Journal of bone and joint surgery. British volume.