Birkedal John P, Deal D Nicole, Ruch David S
Department of Orthopaedic Surgery, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
J Shoulder Elbow Surg. 2004 Mar-Apr;13(2):208-13. doi: 10.1016/j.jse.2003.11.007.
Prosthetic radial head replacement is a well-documented procedure; however, loss of elbow flexion after radial head arthroplasty has only recently been reported. This study reviews 6 patients who received modular prosthetic radial heads and had a clinically significant decrease in elbow flexion. The implant was removed in 4 of these patients because of reduced elbow motion and pain. This clinical finding is correlated with biomechanical data obtained by use of matched-pair, fresh-frozen upper extremity specimens loaded to 330 N with the forearm in positions of neutral, pronation, and supination for each of three elbow positions (0 degrees, 90 degrees, and 135 degrees). The radiocapitellar gap was monitored and was significantly smaller under load during elbow flexion compared with extension. This study indicates the need for verification of the radiocapitellar gap throughout elbow range of motion in order to prevent these complications.
人工桡骨头置换术是一种有充分文献记载的手术；然而，桡骨头置换术后肘关节屈曲功能丧失的情况直到最近才被报道。本研究回顾了6例接受模块化人工桡骨头置换且肘关节屈曲功能出现临床显著下降的患者。其中4例患者因肘关节活动度降低和疼痛而取出了植入物。这一临床发现与通过使用配对的新鲜冷冻上肢标本获得的生物力学数据相关，这些标本在前臂处于中立、旋前和旋后位置时，分别在三个肘关节角度（0度、90度和135度）下加载330N的力。监测了桡骨头间隙，结果显示在肘关节屈曲时，与伸展相比，负荷下的桡骨头间隙明显更小。本研究表明，为防止这些并发症，需要在整个肘关节活动范围内对桡骨头间隙进行验证。
