Title: Early Complications in Total Radial Head Excision & Radial Head Replacement in Comminuted Radial Head Fractures
Authors: Prof. Dr R.Neelakrishnan, Dr P.Murali
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.135
Abstract
Introduction: Comminuted radial head fractures represents one of the troublesome and unpredictable complications which leads to upper limb disability that orthopaedic surgeons face. The two current methods of managing comminuted radial head fracture are excision of the radial head and radial head prosthesis in this study4.
Aim: To assess the early associated complications in radial head excision and radial head prosthesis.
Material & Methodology: The study comprised of 20 patients with unstable elbow injuries, out of 20 cases, 3 cases treated with radial head prosthesis and 4 cases treated with radial head excision .study period was from september 2016 to October 2017 at Rajah Muthiah Medical College, Chidambaram.
Results: There were 7 cases with comminuted radial head fractures. The mean duration of immobilisation was 25.5 (range, 17-38) days. After physical therapy, the mean range of motion of the elbow improved to 1300 flexion (24% recovery), 180 extension (35% recovery), 730 supination (142% recovery), and 850 pronation (25% recovery). The greatest gain in range of motion occurred within 3 to 4 months.
Complications: included wrist pain, proximal migration of radius, heterotopic ossification, restricted rotational motion, degenerative articular changes, radioulnar synostosis in radial head excision. Implant deformation, implant loosening, synovitis, degenerative changes.
Conclusion: Every fracture pattern needs to be managed differently which will give enough stability to start early mobilisation .total radial head excision patients have higher complication rate.
Keywords: Comminuted radial head fractures, outcome, radial head excision and radial head prosthesis.
References
- HARRINGTON, A.A.TOUNTAS Replacement of the radial head in the treatment of unstable elbow fractures; The british journal of accidental surgery vol 12/no.5.
- GANESH F GUPTA, GEORGE LUCAS, DUSTAN L HAHN, Biomechanical and computer analysis of radial head prostheses; Journal shoulder elbow surgery January 1997.
- W.JOHNSTON A follow up of one hundred cases of fracture of the head of the radius with a review of the literature; Fracture and orthopaedic service; Royal victoria hospital, Belfast 51-56.
- RICHARD A SANDERS open reduction and internal fixation of comminuted radial head fractures; the American journal of sports medicine vol 14,No 2.