Primary replacement of the fractured radial head with a metal prosthesis.

Compression testing of cadaver specimens showed that excision of the radial head allowed proximal radial displacement. The insertion of a metallic radial head restored normal mechanics, while a silicone rubber implant did not. We reviewed 31 of 36 comminuted fractures of the radial head, 21 associated with dislocation or ulnar fracture, which had been treated by primary replacement with a Vitallium prosthesis. At a mean follow-up of 4.5 years, there was reliable restoration of stability and prevention of proximal radial migration. There had been no dislocations or prosthetic failures, but two implants had been removed for loosening. The prosthesis is recommended for use as a spacer to stabilise the elbow after severe injuries while the soft tissues heal.

[1]  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.

[2]  Duncan Dowson,et al.  An Examination of the Elbow Articulation with Particular Reference to Variation of the Carrying Angle , 1977 .

[3]  P. Bullough,et al.  Synovial and osseous inflammation in failed silicone-rubber prostheses. , 1982, The Journal of bone and joint surgery. American volume.

[4]  A A Amis,et al.  The derivation of elbow joint forces, and their relation to prosthesis design. , 1979, Journal of medical engineering & technology.

[5]  J. C. Cherry.  Use of acrylic prosthesis in the treatment of fracture of the head of the radius. , 1953, The Journal of bone and joint surgery. British volume.

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

[7]  W. F. Blair,et al.  Resection of the radial head for fracture of the radial head. Long-term follow-up of seventeen cases. , 1987, The Journal of bone and joint surgery. American volume.

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

[9]  Z. Yosipovitch,et al.  Late results of excision of the radial head for an isolated closed fracture. , 1986, The Journal of bone and joint surgery. American volume.