CORR Insights®: High Risk of Further Surgery After Radial Head Replacement for Unstable Fractures: Longer-term Outcomes at a Minimum Follow-up of 8 Years

摘要

Radial head replacement is more akin to silicone arthroplasty of the metacarpophalangeal joint than it is to total hip or knee replacement. A prosthetic radial head is a spacer that keeps the elbow aligned while the ligaments scar. A prosthetic radial head is helpful for stabilizing the elbow during the 3 or 4 weeks after dislocation, particularly when there is an associated fracture of the tip of the coronoid (the so-called “terrible triad fracture-dislocation”). It’s unclear whether a prosthetic radial head improves the health of the elbow more than 4 weeks after dislocation. A prosthetic radial head might limit the development of ulnotrochlear arthritis by helping to support the elbow, but it might cause arthritis by contributing to subluxation if not appropriately sized or an abnormal articular milieu to the degree that a metal articulation with cartilage is unhealthy.