Third Orthopaedic Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Shoulder Elbow Surg. 2012 Sep;21(9):1222-8. doi: 10.1016/j.jse.2011.12.004. Epub 2012 Feb 17.
Radial head fractures often pose therapeutic dilemmas. We present the early results of patients who underwent radial head replacement with the MoPyC prosthesis (Bioprofile, Tornier, Saint-Ismier, France).
We re-evaluated patients who underwent post-traumatic radial head resection and implantation of the MoPyC prosthesis due to pain and motion restriction. All patients underwent radiographic evaluation. Clinical evaluation was performed using the Broberg-Morrey and the Mayo Elbow Performance Score (MEPS) scales.
Thirty-two patients (20 men, 12 women; mean age, 54 years; 22 dominant upper limbs) were evaluated. Twenty had a comminuted radial head fracture (Mason IV, 15; Mason III, 5), 2 from radial head fracture malunion, and 10 had complex elbow injuries (comminuted radial head fractures with ligamentous ruptures with or without coronoid process fractures). Mean follow-up was 27 months (range, 21-46 months). The mean results at the latest follow-up were flexion-extension, 130° (range, 105°-150°); pronation, 74° (range, 60°-80°); and supination, 72° (range, 60°-80°). No laxity was evident during valgus and varus stress tests. Mean grip strength was 96% of the contralateral side. Broberg-Morrey scores were excellent in 33%, good in 44%, and fair in 23%. MEPS results were excellent in 80%, good in 17%, and fair in 3%. There were 6 cases of periprosthetic lucencies or osteolysis of the radius without any clinical signs of loosening.
Radial head replacement with the MoPyC pyrocarbon prosthesis (when performed in carefully selected patients) yields satisfactory results regarding range of motion and function of the elbow joint.
桡骨头骨折常带来治疗上的困境。我们报告采用 MoPyC 假体（Bioprofile，Tornier，Saint-Ismier，法国）行桡骨头置换术的患者的早期结果。
我们对因疼痛和活动受限而行桡骨头切除、MoPyC 假体植入的创伤后患者进行了再评估。所有患者均行影像学评估，采用 Broberg-Morrey 和 Mayo 肘关节功能评分（MEPS）量表进行临床评估。
32 例患者（20 例男性，12 例女性；平均年龄 54 岁；22 例为优势侧上肢）接受了评估。20 例为桡骨头粉碎性骨折（Mason Ⅳ型 15 例，Mason Ⅲ型 5 例），2 例为桡骨头骨折畸形愈合，10 例为复杂肘关节损伤（伴有或不伴有冠状突骨折的桡骨头粉碎性骨折合并韧带断裂）。平均随访时间 27 个月（21-46 个月）。末次随访时的平均结果为：屈伸活动度 130°（105°-150°），旋前 74°（60°-80°），旋后 72°（60°-80°）。在内外翻应力试验时均未见明显松弛。平均握力为健侧的 96%。Broberg-Morrey 评分优 33%，良 44%，可 23%。MEPS 评分优 80%，良 17%，可 3%。6 例出现假体周围透亮线或桡骨骨溶解，但均无假体松动的临床迹象。
在精心选择的患者中，采用 MoPyC 热解碳假体行桡骨头置换可获得满意的活动度和肘关节功能结果。
