Pyrocarbon arthroplasty in acute unreconstructable radial head fractures

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Pyrocarbon arthroplasty in acute unreconstructable radial head fractures
Key Take-Away: 

The radial head is an important secondary stabiliser of the elbow against valgus loading, and the fractures of radial head are common. This retrospective case series showed that the patients recovered a median flexion arch of 113°; hence most of them are classed as satisfactory outcomes which can be expected midterm when using pyrocarbon prostheses.

Introduction:

This study aimed to elucidate the mid-term radiological findings in patients with a pyrocarbon radial head prosthesis and to correspond them to patient symptoms.

 

Methods:

All in all 18 patients who underwent radial head implantation of the MoPyC prosthesis between the year 2004 and 2015, due to unreconstructable radial head fractures were reviewed. Clinical outcomes were measured with the Mayo Elbow Performance Score (MEPS). The range of motion, pain, and elbow radiological assessments was recorded. Non-Parametric, statistical analysis was carried out to examine the radiological findings with the clinical outcomes.

 

Results:

Following a mean follow-up of 6.5 years (2 to11 years), patients have recovered a median flexion arch of 113°; hence 77% are classed as satisfactory outcomes, with an average MEPS score of 89.5. The occurrence of periprosthetic changes on X-ray is commonly observed, the authors found radiolucent lines in 38% cases, radial neck reabsorption in 83%, and arthrosic modifications in 78%. However, the differences observed when correlating these changes with the clinical results have not been statistically significant (p > 0.05).

 

Conclusion:

In about 75% cases the Satisfactory outcomes expected midterm when using pyrocarbon prostheses. The researchers considered radial neck re-absorption to be a sign of good stem osteointegration, on the other hand, progressive radiolucencies and loss of the ballooning of the stem legs are signs of bad prognosis in our series.

Source

J Orthop Traumatol

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30136014

Original title of article:

Pyrocarbon arthroplasty in acute unreconstructable radial head fractures: mid-term to long term results

Authors:

Ricon FJ et al.

Therapeutic, Fracture, Radial head, Retrospective case series, Mayo Elbow Performance Score (MEPS)
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