title: Short- to medium-term outcomes of radial head replacement arthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up.
abstract: BACKGROUND
  The radial head is considered the main stabilizer of the elbow when the medial collateral ligament and lateral ulnar collateral ligament have been compromised. Radial head replacement (RHR) is indicated for patients with irreparable or non-united radial head fractures associated with elbow stiffness or instability. The present study aimed to analyze the clinical results after treatment with titanium radial head prostheses, repair of torn soft tissue constraints, and early mobilization of the elbow.
  
  
  METHODS
  From 2002 to 2008, 13 patients with radial head fractures were included. RHR arthroplasty was performed primarily for irreparable fractures in 10 patients and secondarily for radial head fracture nonunion in 3. All patients were followed-up clinically and radiographically for a mean of 38 months (range, 20 to 70 months).
  
  
  RESULTS
  On the basis of Mayo Elbow Performance Scores, 8 patients had excellent results; 3, good results; and 2, fair results. No patient had elbow instability after RHR. Two patients had elbow stiffness 6 months after RHR and underwent surgical intervention for contracture release. None of the prostheses were removed because of loosening or infection.
  
  
  CONCLUSIONS
  Treatment of irreparable radial head fractures with a modular titanium radial head prosthesis and soft-tissue reconstruction yields satisfactory results. Early mobilization of the elbow is important for the restoration of elbow range of motion and function.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Hung-Yang
authors.initials: HY
authors.lastname: Chien
authors.forename: Alvin Chao-Yu
authors.initials: AC
authors.lastname: Chen
authors.forename: Jau-Wen
authors.initials: JW
authors.lastname: Huang
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Cheng
authors.forename: Kuo-Yao
authors.initials: KY
authors.lastname: Hsu
mesh_terms: D000293:Adolescent; D000328:Adult; D057929:Arthroplasty, Replacement, Elbow; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000150:complications; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome