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PURPOSE: Metallic radial head replacement with a prosthesis that is too thick has been reported to be associated with stiffness, pain, and capitellar wear. Radiographic widening of the lateral ulnohumeral joint after radial head replacement has been used as a criterion to diagnose overstuffing. The purpose of this study was to show that widening of the lateral ulnohumeral joint is a normal anatomic variant and therefore cannot be used conclusively to diagnose joint overstuffing. METHODS: Fifty normal standardized anteroposterior radiographs from 50 patients were reviewed to evaluate variations in the joint space between the medial and lateral ulnohumeral joints. Measurements were taken on 3 occasions by one surgeon and on a single occasion by a second surgeon. At 4-times magnification, 2 lines were drawn perpendicular to the lateral ulnohumeral joint and 2 lines perpendicular to the medial ulnohumeral joint. Measurements were then compared to evaluate joint space width and parallelism. RESULTS: Intraclass correlation coefficients indicated excellent intrarater and interrater reliability. The width of the lateral ulnohumeral joint space was greater than that of the medial ulnohumeral joint space. The medial joint space was parallel, and the lateral joint space was nonparallel. CONCLUSIONS: The lateral ulnohumeral joint space is often wider than the medial ulnohumeral joint space on anteroposteror radiographs of the normal elbow. Although the medial joint space is usually parallel, the lateral joint space may be nonparallel and wider laterally; therefore, lateral joint space widening is not a reliable indicator of radiocapitellar joint overstuffing. A nonparallel medial ulnohumeral joint space may suggest possible overstuffing of a radial head arthroplasty; however, comparing radiographs of the uninjured elbow is likely the best investigation to consider when overstuffing is suspected. 相似文献
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George Miller Ali Humadi Raghavan Unni Raphael Hau 《Indian Journal of Orthopaedics》2013,47(4):323-332
The evidence for optimal management of Mason type III fracture of radial head is unclear hence a systematic review of the published literature was performed in April 2012. This review includes 5 prospective studies (including 2 randomized trials), 4 retrospective studies and 9 case series. No study can be interpreted as level 1 evidence. Level 2 and 3 evidence provides some insight into the success of each modality through subjective and objective measurements of function and complication rates. Radial head replacement, open reduction internal fixation (ORIF) and radial head resection all provide satisfactory outcomes for patients in most cases. One treatment modality cannot be recommended over any other due to the small number of clinical trials and cases included in each study. Further randomized control trials are needed to evaluate the full benefits and shortcomings of each of the different surgical treatment modalities. 相似文献
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《Journal of Clinical Orthopaedics and Trauma》2020,11(2):324-327
Radial neck fractures account for 1% of all paediatric fractures and constitute 5–10% of elbow injuries. Radial neck fractures rarely occur at age 2 or less. It is difficult to assess and reduce radial neck fractures in children with unossified radial head. We report a case of 2 years old female child presented to emergency with history of fall from stairs on an outstretched hand. Radiograph showed a metaphyseal spike in the proximal radius which prompted us to think of a radial neck fracture. Since the radial head was not ossified, the amount of displacement and angulation was not exactly quantifiable on radiographs only. Hence an arthrogram was planned. Intra operative use of radio opaque dye injection into elbow joint delineates the radial head and capitellum. It helps in identifying the fracture morphology and will also assist in reduction. We reduce radial head by K wire leverage technique and the intramedullary elastic titanium nail was added to assist in reduction and to improve fixation stability. We recommend arthrogram to be a safe and reliable option for proper assessment and reduction of radial neck fracture in an unossified radial head. 相似文献
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Radial head arthroplasty 总被引:1,自引:0,他引:1