[Radial Head Arthroplasty: Pearls and Pitfalls].

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2025-02-01 Epub Date: 2025-02-04 DOI:10.1055/a-2342-1642
Jan Philipp Hockmann, Valentin Rausch, Tim Leschinger, Lars P Müller
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引用次数: 0

Abstract

Fractures of the radial head are among the more common injuries of the upper extremity. Their incidence is increasing, and these fractures are often associated with ligamentous injuries or occur as part of complex injury patterns, such as the terrible triad, Monteggia-like lesions, or Essex-Lopresti injuries. Radial head fractures are classified according to the Mason/Johnston system. In cases where the fracture is not reconstructable, or when osteosynthesis fails, radial head arthroplasty may be indicated.Several prosthetic designs are available, each offering unique features. These include differences in polarity, modularity, and shaft fixation techniques, such as cemented, cementless, or "intentionally loose" fixation. This article, supported by case reports, highlights the indications, surgical approach, and implantation techniques for radial head arthroplasty. Additionally, common pitfalls are discussed, along with strategies to prevent or manage them. These pitfalls include postoperative elbow stiffness, elbow joint instability, and prosthetic overstuffing.

桡骨头骨折是上肢最常见的损伤之一。其发病率呈上升趋势,这些骨折通常伴有韧带损伤或作为复杂损伤模式的一部分出现,如可怕的三联症、Monteggia样病变或Essex-Lopresti损伤。桡骨头骨折根据梅森/约翰斯顿系统进行分类。在骨折无法重建或骨合成失败的情况下,可能需要进行桡骨头关节成形术。有多种假体设计可供选择,每种设计都有其独特之处,包括极性、模块化和轴固定技术的不同,如骨水泥固定、无骨水泥固定或 "有意松动 "固定。本文结合病例报告,重点介绍了桡骨头关节成形术的适应症、手术方法和植入技术。此外,文章还讨论了常见的误区以及预防或处理这些误区的策略。这些陷阱包括术后肘关节僵硬、肘关节不稳定和假体过度充填。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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