Müller M C, Burger C, Striepens N, Wirtz C D, Weber O
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
Z Orthop Unfall. 2008 Mar-Apr;146(2):218-26. doi: 10.1055/s-2008-1038333.
Long-term results after resection of comminuted fractures of the radial head (Mason III and IV) may lead to valgus elbow instability, radius proximalisation and rotatory instability. Radial head replacement has been used to prevent and treat these complications. The aim of this study was to define the value of the bipolar radial head prosthesis of Judet for treating comminuted fractures of the radial head.
Over a 5-year period, 14 radial head prosthesis were implanted in 12 patients. Retrospectively, we studied the clinical and radiological results.
Eleven patients with thirteen implants were analysed at a mean follow-up of 33.4 +/- 20.4 months. In all patients, the elbow was stable. Subjectively, we found good and excellent results with one exception. Compared to the pre-trauma status, the subjective rate was 78 +/- 12 %. According to the score of Radin and Riseborough, five of the results were found to be good and eight to be fair. According to the Broberg and Morrey score, one result was found to be very good, seven to be good and five to be fair. The mean DASH score was 10.2 +/- 10.1 points. Two temporary nerve lesions were observed.
In comminuted fractures of the radial head (Mason III and IV), bipolar radial head replacement with the Judet prosthesis leads subjectively to very good and good and functionally to good and fair results on the medium-term view. Joint stability is achieved and secondary complications like valgus elbow deformity and proximal radial migration are prevented. Patients must be informed about the possibility of temporary nerve lesions, heterotopic ossification causing limitation of motion and the lack of long-term results.
桡骨头粉碎性骨折（梅森Ⅲ型和Ⅳ型）切除术后的长期结果可能导致肘外翻不稳定、桡骨近端上移和旋转不稳定。桡骨头置换术已被用于预防和治疗这些并发症。本研究的目的是确定Judet双极桡骨头假体治疗桡骨头粉碎性骨折的价值。
在5年期间，12例患者植入了14个桡骨头假体。我们回顾性地研究了临床和放射学结果。
对11例患者的13个植入物进行了分析，平均随访时间为33.4±20.4个月。所有患者的肘部均稳定。主观上，除1例例外，我们发现结果良好。与创伤前状态相比，主观评分率为78±12%。根据Radin和Riseborough评分，5例结果为良好，8例为一般。根据Broberg和Morrey评分，1例结果为非常好，7例为良好，5例为一般。平均DASH评分为10.2±10.1分。观察到2例暂时性神经损伤。
对于桡骨头粉碎性骨折（梅森Ⅲ型和Ⅳ型），使用Judet假体进行双极桡骨头置换术，从中期来看，主观上可获得非常好和良好的结果，功能上可获得良好和一般的结果。实现了关节稳定性，预防了肘外翻畸形和桡骨近端移位等继发性并发症。必须告知患者存在暂时性神经损伤、异位骨化导致运动受限以及缺乏长期结果的可能性。
