[Clinical results after replacement of comminuted radial head fractures (Mason III and IV) by the bipolar radial head prosthesis of Judet].
OBJECTIVE
Long-term results after resection of comminuted fractures of the radial head (Mason III and IV) may lead to valgus elbow instability, radius proximalisation and rotatory instability. Radial head replacement has been used to prevent and treat these complications. The aim of this study was to define the value of the bipolar radial head prosthesis of Judet for treating comminuted fractures of the radial head.


METHODS
Over a 5-year period, 14 radial head prosthesis were implanted in 12 patients. Retrospectively, we studied the clinical and radiological results.


RESULTS
Eleven patients with thirteen implants were analysed at a mean follow-up of 33.4 +/- 20.4 months. In all patients, the elbow was stable. Subjectively, we found good and excellent results with one exception. Compared to the pre-trauma status, the subjective rate was 78 +/- 12 %. According to the score of Radin and Riseborough, five of the results were found to be good and eight to be fair. According to the Broberg and Morrey score, one result was found to be very good, seven to be good and five to be fair. The mean DASH score was 10.2 +/- 10.1 points. Two temporary nerve lesions were observed.


CONCLUSIONS
In comminuted fractures of the radial head (Mason III and IV), bipolar radial head replacement with the Judet prosthesis leads subjectively to very good and good and functionally to good and fair results on the medium-term view. Joint stability is achieved and secondary complications like valgus elbow deformity and proximal radial migration are prevented. Patients must be informed about the possibility of temporary nerve lesions, heterotopic ossification causing limitation of motion and the lack of long-term results.
Müller
M C
MC
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn. marcus.mueller@yahoo.de
Burger
C
C
Striepens
N
N
Wirtz
C D
CD
Weber
O
O
D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D000092464:Elbow Injuries