Arbter D, Piatek S, Probst A, Holmenschlager F, Winckler S
Klinik für Unfallchirurgie, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
Unfallchirurg. 2012 Nov;115(11):1000-8. doi: 10.1007/s00113-011-1990-1.
With regard to the treatment of non-reconstructable radial head fractures, both the resection and the implantation of a prosthesis are considered. Various studies have shown poor results concerning the resection of the radial head with accompanying osteoligamentous injuries. Due to these experiences, different types of prosthesis have been developed. However, the majority of them were not convincing. Judet developed a type of a bipolar prosthesis which had been modeled on the anatomy of the radial head. The aim of our retrospective study consists in examining the results of the Judet prosthesis.
Between 1995 and 2007, 50 patients were treated with an arthroplasty. These were, corresponding to the classification by McKee and Jupiter, 19 type III and 31 type IV fractures. Thirty patients were available for a follow-up after 2.5 years on average.
According to the Morrey Score, 16 very good, 7 good, 3 fair and 4 bad results could be obtained. Following the criteria of Radin and Riseborough, 17 patients achieved a good, 9 a fair and 4 a bad result. The complications which appeared were: one patient with aseptic loosening, one patient with luxation of a prosthesis, one persistent radial joint instability, three patients with heterotopic ossification and four patients with protrusion relative to the capitulum humeri.
关于不可重建的桡骨头骨折的治疗,桡骨头切除术和假体植入术均被纳入考虑范围。多项研究表明,伴有骨韧带损伤的桡骨头切除术效果不佳。基于这些经验,人们开发了不同类型的假体。然而,其中大多数都不尽人意。朱代特研发了一种双极假体,该假体是根据桡骨头的解剖结构设计的。我们这项回顾性研究的目的在于检验朱代特假体的治疗效果。
1995年至2007年间,50例患者接受了关节成形术治疗。根据麦基和朱庇特的分类标准,其中有19例III型骨折和31例IV型骨折。平均2.5年后,30例患者接受了随访。
根据莫里评分标准,可获得16例优、7例良、3例中、4例差的结果。按照拉丹和里斯博罗的标准,17例患者结果为良,9例为中,4例为差。出现的并发症有:1例无菌性松动、1例假体脱位、1例持续性桡关节不稳定、3例异位骨化以及4例相对于肱骨小头的突出。