SHORT TERM RESULTS OF REPLACEMENT ARTHROPLASTY IN IRREPERABLE MASON TYPE III RADIAL HEAD FRACTURES

Volume : VII, Issue : VII, July - 2018

Anish Agarwalla, Lg Krishna, Akshat Sharma, Ketan Pandey

Background: The radial head is considered as the main stabilizer of the elbow especially when the medial and

lateral ulnar collateral ligaments have been damaged. Radial head arthroplasty (RHA) is indicated for patients with

unreconstructible radial head fractures or previously treated radial head fractures leading to non-union, irrespective of the mode of

treatment given. The present study was carried out to analyze the early clinical results after treatment of irreparable radial head fractures

with radial head replacement.

Methods:32 patients with Mason‘s type III radial head fractures were treated with cemented monoblock radial head replacement during

2014-2016. The patients were followed up for a period ranging from minimum of 12 months to a maximum of 23 months, with average

being 1 year. During each visit their functional outcome with any associated complications were noted and were graded with Mayo‘s elbow

performance score(MEPS).

Results: At the 􀃶nal follow up, 24 patients (75%) had excellent results, 6 (18.75%) good and two (6.25%) had fair results. 6 patients were

associated with complications like pain, stiffness and valgus elbow instability. Variables like MEPS, pain and stiffness were found to have

signi􀃶cant association with time interval between injury and surgery, with cases being operated earlier showing better results. Signi􀃶cant

association was also seen between associated elbow injury and elbow instability. No case of radiocapitellar overstuffing was seen. However

, one case was associated with lateral epicondylitis which is a relatively rare non-documented complication.

Conclusion: We conclude that radial head arthroplasty is a good treatment option for irreparable type III radial head fractures, with cases

operated earlier showing better results. It restores elbow kinematics and stability with good functional outcome, provided care has been

taken to avoid overstuffing of the joint. Early mobilisation of elbow is important to restore elbow motion and function.