Chen Hongwei, Wang Ziyang, Shang Yongjun
a Department of Orthopedics , Wenzhou Medical College-Affiliated Yiwu Central Hospital , Yiwu, Zhejiang , China.
b Department of Orthopedics , Dalian University Affiliated Xinhua Hospital , Dalian , Liaoning , China.
J Invest Surg. 2018 Jun;31(3):178-184. doi: 10.1080/08941939.2017.1299262. Epub 2017 Sep 13.
To compare clinical outcomes of unipolar and bipolar radial head prosthesis in the treatment of patients with radial head fracture.
Medline, Cochrane, EMBASE, Google Scholar databases were searched until April 18, 2016 using the following search terms: radial head fracture, elbow fracture, radial head arthroplasty, implants, prosthesis, unipolar, bipolar, cemented, and press-fit. Randomized controlled trials, retrospective, and cohort studies were included.
The Mayo elbow performance score (MEPS), disabilities of the arm, shoulder, and hand (DASH) score, radiologic assessment, ROM, and grip strength following elbow replacement were similar between prosthetic devices. The pooled mean excellent/good ranking of MEPS was 0.78 for unipolar and 0.73 for bipolar radial head arthroplasty, and the pooled mean MEPS was 86.9 and 79.9, respectively. DASH scores for unipolar and bipolar prosthesis were 19.0 and 16.3, respectively. Range of motion outcomes were similar between groups, with both groups have comparable risk of flexion arc, flexion, extension deficit, rotation arc, pronation, and supination (p values <0.001 for both unipolar and bipolar prosthesis). However, bipolar radial head prosthesis was associated with an increased chance of heterotopic ossification and lucency (p values ≤0.049) while unipolar prosthesis was not (p values ≥0.088). Both groups had risk for development of capitellar osteopenia or erosion/wear (p values ≤0.039).
Unipolar and bipolar radial head prostheses were similar with respect to clinical outcomes. Additional comparative studies are necessary to further compare different radial head prostheses used to treat radial head fracture.
比较单极和双极桡骨头假体治疗桡骨头骨折患者的临床疗效。
使用以下检索词检索Medline、Cochrane、EMBASE、谷歌学术数据库直至2016年4月18日：桡骨头骨折、肘部骨折、桡骨头置换术、植入物、假体、单极、双极、骨水泥固定和压配。纳入随机对照试验、回顾性研究和队列研究。
假体装置之间，肘关节置换术后的梅奥肘关节功能评分（MEPS）、上肢、肩部和手部功能障碍（DASH）评分、影像学评估、活动范围（ROM）和握力相似。单极桡骨头置换术的MEPS汇总平均优良率为0.78，双极桡骨头置换术为0.73，MEPS汇总平均值分别为86.9和79.9。单极和双极假体的DASH评分分别为19.0和16.3。两组间活动范围结果相似，两组在屈曲弧、屈曲、伸展不足、旋转弧、旋前和旋后的风险相当（单极和双极假体的p值均<0.001）。然而，双极桡骨头假体发生异位骨化和透亮区的几率增加（p值≤0.049），而单极假体则无此情况（p值≥0.088）。两组均有发生肱骨头骨质减少或侵蚀/磨损的风险（p值≤0.039）。
单极和双极桡骨头假体在临床疗效方面相似。需要进行更多的比较研究以进一步比较用于治疗桡骨头骨折的不同桡骨头假体。
