Viswanath Aparna I, Watts Adam C
Upper Limb Unit, Department of Orthopaedics, Wrightington Hospital, Lancashire, UK.
Shoulder Elbow. 2022 Aug;14(4):426-433. doi: 10.1177/17585732211024182. Epub 2021 Jun 17.
Restoring the radial head as a stabiliser of the elbow is considered important in cases where there is an associated bony or ligamentous injury. A variety of radial head prostheses are available. There are no reports of the survivorship of a short-stem press-fit radial head prostheses with pyrocarbon bearing.
With institutional review board approval, a retrospective case-note analysis was performed of a consecutive single-surgeon case series of the Integra LifeScience pyrocarbon radial head prostheses (Carbon Modular Radial Head) from October 2010 to October 2019 in a tertiary referral centre. The series was divided into acute trauma and salvage cohorts. Kaplan-Meier survivorship analysis was conducted.
36 patients were included, 23 (64%) for acute injuries and 13 (36%) for failed initial treatment. Of the acute injuries, 20 (87%) had a Wrightington type-C elbow fracture-dislocation. Reoperation was performed in 4 (11%) patients; 10 (28%) had possible loosening on radiographs. The implant survival rate was 94% at shortest follow-up of 17 months (mean 70 months).
Treatment of complex radial head fractures using a pyrocarbon-bearing, anatomic press-fit design provides satisfactory short-term survivorship in this case series. The implant should be used with caution in salvage cases, due to higher rates of loosening seen in this cohort.
在伴有骨或韧带损伤的情况下，恢复桡骨头作为肘关节稳定器的功能被认为很重要。有多种桡骨头假体可供选择。目前尚无关于带热解碳轴承的短柄压配式桡骨头假体生存率的报道。
在获得机构审查委员会批准后，对2010年10月至2019年10月在一家三级转诊中心由同一位外科医生连续进行的Integra LifeScience热解碳桡骨头假体（碳模块化桡骨头）病例系列进行回顾性病例记录分析。该系列分为急性创伤组和挽救组。进行了Kaplan-Meier生存率分析。
共纳入36例患者，其中23例（64%）为急性损伤，13例（36%）为初始治疗失败。在急性损伤患者中，20例（87%）为Wrightington C型肘关节骨折脱位。4例（11%）患者进行了再次手术；10例（28%）患者在X线片上显示可能存在松动。最短随访17个月（平均70个月）时，植入物生存率为94%。
在本病例系列中，使用带热解碳轴承的解剖型压配设计治疗复杂桡骨头骨折可提供令人满意的短期生存率。由于该组患者松动率较高，在挽救病例中应谨慎使用该植入物。
