Department of Orthopaedic Surgery and Traumatology, Emsey Hospital, Istanbul, Turkey.
Faculty of Health Sciences, Istanbul Yeni Yüzyıl University, Istanbul, Turkey.
Eur J Orthop Surg Traumatol. 2022 Dec;32(8):1517-1524. doi: 10.1007/s00590-021-03129-3. Epub 2021 Sep 26.
The aim of this study was to evaluate the possible effect of radiographic loosening on clinical and functional outcomes, while presenting the mid-term radiographic and functional outcomes of cemented, monopolar RHA applied to patients with comminuted radial head fractures.
We performed a retrospective study by evaluating the records of patients who were diagnosed in a single center with radial head fractures between 2001 and 2013. Twenty-six patients with comminuted radial head fractures with a mean age of 48.9 and a mean follow-up time of 132.2 months were included. The radiographic evaluation was performed by assessing peri-prosthetic radiolucent lines around the stem to evaluate loosening, while the clinical evaluation was performed by utilizing elbow range of motion (ROM), Mayo elbow performance score (MEPS), Oxford elbow score (OES) and quick-DASH scores.
13 patients (Group 1) with peri-prosthetic stem lucency were defined as radiographic loosening (50%), while the remaining 13 patients (Group 2) were not detected to have stem lucency. One patient in group 1 also had concomitant pain and underwent removal of the prosthesis, while 12 patients (92.3%) remained pain-free. On the latest follow-up visit, there was no significant difference between the groups regarding ROM, MEPS, OES and quick-DASH scores.
Within ten years following surgery, half of the patients with radial head prostheses were noted to show radiographic signs of loosening which did not have any major negative effect in terms of clinical-functional outcomes and quality of life, except requiring the removal of the implant in one patient.
Level III.
本研究旨在评估放射学松动对临床和功能结果的可能影响，同时介绍应用于粉碎性桡骨头骨折患者的骨水泥固定单极 RHA 的中期放射学和功能结果。
我们通过评估 2001 年至 2013 年在单一中心诊断为桡骨头骨折的患者的记录进行了回顾性研究。纳入 26 例粉碎性桡骨头骨折患者，平均年龄 48.9 岁，平均随访时间 132.2 个月。通过评估假体周围的 stem 周围放射性透明线来评估松动情况，进行放射学评估，而临床评估则通过测量肘部活动范围 (ROM)、Mayo 肘功能评分 (MEPS)、牛津肘评分 (OES) 和快速-DASH 评分来进行。
13 例（组 1）患者假体周围 stem 出现透亮线，定义为放射学松动（50%），而其余 13 例（组 2）患者未发现 stem 透亮线。组 1 中有 1 例患者同时出现疼痛并接受了假体取出，而 12 例患者（92.3%）无疼痛。在最新的随访中，两组患者在 ROM、MEPS、OES 和快速-DASH 评分方面无显著差异。
在手术后十年内，一半的桡骨头假体患者出现放射学松动迹象，但在临床功能结果和生活质量方面没有产生任何重大负面影响，除了 1 例患者需要取出植入物。
III 级。
