Safdarjung Hospital and VMM College, India
Anish Agarwalla did his post-graduation from Central Institute of Orthopedics, Safdarjung Hospital, New Delhi and is currently serving as senior resident at the same place. He is highly interested is academics and research related works. He is the co-author of two books and is looking forward for more books in near future. The author is highly interested in joint disorders and wants to pursue his career in arthroplasty. His clinical practice is based on very sound principles and he is a person with firm dedication towards his patients and has friendly relations to his students.
Background: The radial head is considered as the main stabilizer of the elbow especially when the medial and lateral ulnar collateral ligaments have been damaged. Radial head arthroplasty (RHA) is indicated for patients with unreconstructible radial head fractures. The present study was carried out to analyse the early clinical results after treatment of irreparable radial head fractures with radial head replacement.
Methods: 32 patients with Mason’s type III radial head fractures were treated with cemented Monoblock stainless steel radial head replacement during 2014-2016. The patients were followed up for a period ranging from minimum of 12 months to a maximum of 23 months, with average being 16 months. During each visit their functional outcome with any associated complications were noted and were graded with Mayo’s elbow performance score (MEPS).
Results: At the final follow up, 24 patients (75%) had excellent results, 6 (18.75%) good and two (6.25%) had fair results. 6 patients were associated with complications like pain, stiffness and valgus elbow instability. Variables like MEPS, pain and stiffness were found to have significant association with time interval between injury and surgery, with cases being operated earlier showing better results. Significant association was also seen between associated elbow injury and elbow instability. No case of radio capitellar overstuffing was seen. However, one case was associated with lateral epicondylitis which is a relatively rare non-documented complication.
Conclusion: We conclude that radial head arthroplasty is a good treatment option for irreparable type III radial head fractures, with cases operated earlier showing better results. It restores elbow kinematics and stability with good functional outcome, provided care has been taken to avoid overstuffing of the joint. Early mobilisation of elbow is important to restore elbow motion and function.