Comparative study of radial head resection and prosthetic replacement in surgical release of stiff elbows.
OBJECTIVE
Elbow trauma can compromise the arc of elbow flexion and forearm rotation. This study aimed at comparing the outcomes of radial head resection and prosthetic replacement in the surgical release of post traumatic elbow stiffness and associated restriction in forearm rotation.


METHODS
We retrospectively reviewed the data of patients who underwent open arthrolysis with radial head resection (n = 15; resection group) or radial head replacement (n = 19; replacement group). The pre- and postoperative measurements of the elbow range of motion (ROM) were recorded. Elbow function was evaluated by the Broberg and Morrey Evaluation System; the Mayo Elbow Performance Index (MEPI); and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.


RESULTS
Over a mean follow-up duration of 22 months, the improvement in the arc of flexion and extension was 79° (range, 45-125°) and 82° (range, 10-110°), while that in the ROM for forearm rotation was 96° (range, 40-150°) and 102° (range, 15-150°) in the resection and replacement groups, respectively. There were no significant intergroup differences in the elbow ROM measured at the last follow up. The Broberg and Morrey, MEPI, and Dash scores in the two groups were comparable.


CONCLUSIONS
Both resection and prosthetic replacement of the radial head with open arthrolysis of post traumatic elbow stiffness were feasible in treating the associated restriction of forearm rotation. We recommend that if the elbow is stable after complete release, radial head resection is preferable to prosthetic replacement because it is technically less demanding.
Department of Orthopaedics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
Shi-yang
SY
Yu
He-de
HD
Yan
Hong-jiang
HJ
Ruan
Wei
W
Wang
Cun-yi
CY
Fan
D000293:Adolescent; D000328:Adult; D004551:Elbow Joint / Q000601:surgery*; D058569:Elbow Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011884:Radius / Q000293:injuries / Q000601:surgery*; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries