The use of frozen-allograft radial head replacement for treatment of established symptomatic proximal translation of the radius: preliminary experience in five cases.
Five patients with disabling symptoms related to proximal translation (> 1 cm) of the radius following radial head excision (Essex-Lopresti lesion) were treated with implantation of a frozen-allograft radial head prosthesis. Following restoration of neutral ulnar variance at the wrist, a size-matched frozen radial head allograft was implanted and secured to the proximal radius with internal fixation. In three patients, this was a two-stage procedure; radial length was restored gradually using an ilizarov external fixation device and the allograft was placed later. Patients were evaluated clinically and radiographically at a mean follow-up time of 3 years (range, 1-7 years). All patients had relief of wrist and elbow pain and were satisfied with the outcome of the operation. Forearm rotation improved by a mean of 37 degrees and wrist motion improved by a mean of 45 degrees. Forearm reconstruction with frozen radial head allograft implantation may be a beneficial method of treatment for this difficult problem.
Szabo
R M
RM
Department of Orthopaedic Surgery, University of California, Davis, Sacramento 95817, USA.
Hotchkiss
R N
RN
Slater
R R
RR
D000328:Adult; D001852:Bone Lengthening / Q000295:instrumentation / Q000379:methods; D001860:Bone Plates; D001863:Bone Screws; D015925:Cryopreservation; D004551:Elbow Joint; D016267:External Fixators; D005500:Follow-Up Studies; D005542:Forearm / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D017060:Patient Satisfaction; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery / Q000637:transplantation*; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012399:Rotation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery; D014955:Wrist Joint / Q000503:physiopathology