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Radial head fractures

Taku Hatta, Shingo Nobuta, Toshitake Aizawa, Koichi Sasajima, Soichi Nakajima, Masahito Honda, Gosuke Oki, Yoshiaki Yamanaka, Eiji Itoi
The aim of our study is to evaluate the clinical and radiologic outcomes in patients with terrible triad injury, who underwent surgical treatment with or without the medial collateral ligament (MCL) repair. Fourteen patients who underwent surgery with a minimum of 12-month follow-up (mean, 17 months) were reviewed. Based on the systematic treatment protocol, radial head fracture, lateral collateral ligament, and coracoid fracture were treated. Subsequently, torn MCL was repaired in 7 patients, whereas in the remaining 7 patients, the MCL was not treated...
September 19, 2016: Orthopedic Reviews
Enrico Bellato, Roberto Rotini, Alessandro Marinelli, Enrico Guerra, Shawn W O'Driscoll
BACKGROUND: Chronic coronoid deficiency can occur subsequent to coronoid fracture malunion/nonunion or to coronoid hypoplasia or dysplasia resulting from injury during development. Several surgical options have been described to treat this difficult condition, but results are equivocal. We hypothesized that a modified coronoid reconstruction using a radial head osteochondral graft could restore elbow stability and congruity and that a technique involving rigid internal fixation would promote graft union...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Eugene T H Ek, Sophia K Paul, Robert N Hotchkiss
BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Dipit Sahu, James S Fitzsimmons, Andrew R Thoreson, Kai-Nan An, Shawn W O'Driscoll
BACKGROUND: Metallic radial head prostheses are often used in the management of comminuted radial head fractures and elbow instability. We hypothesized that during radiocapitellar subluxation, the contact pressure characteristics of an anatomic radial head prosthesis will more closely mimic those of the native radial head compared with a monopolar circular or a bipolar circular radial head design. MATERIALS AND METHODS: With use of 6 fresh frozen cadaver elbows, mean radiocapitellar contact pressures, contact areas, and peak pressures of the native radial head were assessed at 0, 2, 4, and 6 mm of posterior subluxation...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Kenneth Chin, Scott H Kozin, Martin Herman, Bernard D Horn, Craig P Eberson, Donald S Bae, Joshua M Abzug
Monteggia fracture-dislocations typically involve a dislocation of the radial head with an associated fracture of the ulnar shaft. The prompt diagnosis and treatment of these acute injuries result in excellent outcomes. Unfortunately, a Monteggia fracture-dislocation is often missed during diagnostic testing and results in a chronic Monteggia fracture-dislocation. The subsequent timing and treatment of chronic Monteggia fracture-dislocations are debatable because outcomes are suboptimal. Therefore, it is critical that the initial injury be correctly diagnosed and treated as close to the time of injury as possible to ensure excellent outcomes...
February 15, 2016: Instructional Course Lectures
Deepak N Bhatia
Displaced radial head fractures are treated with open reduction and internal fixation using implants. Failure of fixation may occur in the presence of comminution and in multifragmentary fractures; open surgical approaches are necessary for removal of the implants and radial head resection. Arthroscopic radial head resection has been described as a minimally invasive and effective treatment for failed radial head fracture fixation; however, periarticular adhesions and prominent implants add to the complexity and technical difficulty of the procedure...
August 2016: Arthroscopy Techniques
Yaiza Lópiz, Ana González, Carlos García-Fernández, Javier García-Coiradas, Fernando Marco
INTRODUCTION: At present, surgical treatment of comminuted radial head fractures without associated instability continues to be controversial. When anatomical reconstruction is not possible, radial head excision is performed. However, the appearance of long-term complications with this technique, along with the development of new radial head implants situates arthroplasty as a promising surgical alternative. The purpose of the present study was to compare the mid-term functional outcomes of both techniques...
September 2016: Injury
E Van Hoecke, A Van De Vijver, F Van Glabbeek, J Gielen
Radial head fractures are common injuries, occurring mostly in active young people 85%. Treatment of the more complex radial head fractures (Mason type III and IV), appear to be challenging and remain a subject of controversy. Replacement of the radial head with a metal prosthesis imitates the stabilizing role of the radial head and has been considered as the treatment of choice. However, long-term results are scarce. We report our mid to long-term (mean 9.4 year) clinical and radiographic results after insertion of a Judet Bipolar Radial Head prosthesis...
August 2016: Acta Orthopaedica Belgica
F M A P Claessen, A R Kachooei, K K J Verheij, G P Kolovich, Chaitanya S Mudgal
BACKGROUND: Radial head compression against the capitellum may cause concomitant fracture of the capitellum. The purpose of this study was to investigate if radial head fracture type is associated with a concomitant fracture of the capitellum. PATIENTS AND METHODS: Data were identified from five area hospitals. We retrieved records of patients older than 18 years of age who underwent treatment for concomitant capitellum fracture and radial head fracture between January 2002 and January 2013...
August 2016: Journal of Hand and Microsurgery
William R VanWye, Donald L Hoover, Sean Willgruber
BACKGROUND AND PURPOSE: Elbow pain can originate from many sources yet have similar signs and symptoms, thereby presenting differential diagnostic challenges. The elbow is commonly injured, thus requiring all clinicians to possess excellent diagnostic skills. CASE DESCRIPTION: A 24-year-old woman slipped and fell on her outstretched left hand, experiencing immediate elbow pain. The same day radiographs were deemed negative by her orthopedist, who referred her to physical therapy with the diagnoses of elbow sprain and contusion...
October 2016: Physiotherapy Theory and Practice
Jesse James Johnston, Lynda Spelman
BACKGROUND: Granuloma annulare is a benign, inflammatory skin disorder with no distinct aetiology or widely accepted pathogenic process. CASE DESCRIPTION AND METHODS: We report a case of a 71-year old female with a 4-year history of an erythematous annulopapular lesion to the lateral aspect of her right forearm from a pressure pleat ridge in a high-density polyethylene plastic elbow orthosis to immobilise a prior radial head fracture. Morphological and histopathological assessment was consistent for granuloma annulare...
September 9, 2016: Prosthetics and Orthotics International
Salvatore Bisicchia, Cosimo Tudisco
Fracture-dislocations of the elbow can be difficult to treat, with unsatisfactory results in some cases. In general, it is preferable to preserve the fractured radial head when possible, but some patients present a unique treatment challenge because of extremely comminuted fractures and bone loss. In these cases, the only options available are radial head prosthesis or allograft. The authors present a case of a 45-year-old man with a fracture-dislocation of the left elbow that was treated with an allograft of the radial head and neck because of extreme comminution of the fracture...
September 8, 2016: Orthopedics
Andrea Emilio Salvi
Multifragmentary fractures of the radial head (Mason type 3) are challenging for the surgeon. They are usually treated by means of complete removal of the injured head and sometimes by implantation of a metal prosthesis. Indeed, the bone fragments are often too small to allow stabilization through screws or even wires. The Author proposes an alternative technique, tested on a sawbone model, in which bioabsorbable thread is used, introduced in a figure-of-eight fashion. A review of the literature is provided...
April 2016: Joints
K Schmidt-Horlohé, S Buschbeck, D Wincheringer, M Weißenberger, R Hoffmann
Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently...
October 2016: Der Orthopäde
Mehmet Demirel, Yavuz Sağlam, Onur Tunalı
INTRODUCTION: The main goal of the treatment is the anatomical reduction of the ulna fracture and the radial head dislocation in acute and chronic Monteggia cases. Acute pediatric Monteggia lesions are generally treated non-surgically; however, the treatment of chronic Monteggia is challenging. The aim of this article is to share our experiences about treatment of neglected Monteggia lesion. PRESENTATION OF CASE: A 6-year-old girl who underwent a surgery in our clinic for a missed Bado type-III Monteggia fracture-dislocation of the right elbow with concomitant posterior interosseous nerve (PIN) palsy, which resolved spontaneously after the operation...
2016: International Journal of Surgery Case Reports
Stefania Vanni, Stefano Marenco, Michel Calò, Bruno Battiston
Radial head represents a secondary elbow stabilizer for varus-valgus and postero-lateral stress. In complex fractures, that cannot be synthesized, the presence of associated ligament injuries makes radial head replacement necessary to restore elbow stability. This study evaluates how the elbow responds to a prosthetic removal after a complex injury repair.
2016: Case Reports in Plastic Surgery & Hand Surgery
John W Karl, Lauren H Redler, Peter Tang
BACKGROUND: Long-term outcomes of radial head resection for radial head fracture have shown mixed outcomes, depending on the integrity of the soft-tissue stabilizers of the elbow, forearm, and wrist. METHODS: We report a case of a symptomatic delayed proximal migration of the radius after radial head excision for radial neck nonunion which was managed with a staged radial head replacement. Informed consent was obtained from the individual in this case report. RESULTS: At 7 months after radial head replacement, the patient had 90 degrees of forearm supination and 85 degrees of pronation...
2016: Iowa Orthopaedic Journal
Andras Heijink, Izaäk F Kodde, Paul G H Mulder, C Niek Van Dijk, Denise Eygendaal
BACKGROUND: Theoretical advantages of bipolar over monopolar radial head arthroplasty include better accommodation of radiocapitellar malalignment, reduction of capitellar abrasion, and reduction of stress at the bone-to-cement and cement-to-implant interfaces. Our purpose was to report the midterm results of cemented bipolar radial head arthroplasty. METHODS: Twenty-five patients were treated by cemented bipolar radial head arthroplasty for acute fracture of the radial head, earlier treatment that had failed, or posttraumatic sequelae...
November 2016: Journal of Shoulder and Elbow Surgery
David C Ring, Neal C Chen, George S Athwal
No abstract text is available yet for this article.
August 9, 2016: Clinical Orthopaedics and related Research
Su-Mi Shin, Jee Won Chai, Ja Yeon You, Jina Park, Kee Jeong Bae
"Buttonholing" of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign...
October 2016: Skeletal Radiology
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