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Functional outcomes of patients with comminuted radial head fracture undergoing radial head arthroplasty

Surinder Singh Ajrawat, Joseph J B Mal, Kashish Talwar, Chetan Goyal.




Abstract

Background: The functional stability of the elbow joint can be effectively restored in acute care for comminuted radial head fractures (RHFs) complicated with secondary ligamentous or bony injuries through the use of a metallic radial head implant.

Aims and Objectives: This study aimed to evaluate the efficiency of modular metallic radial head implant EVOLVE® prosthesis in restoring the functional range of motion and elbow joint stability in acute care.

Materials and Methods: A prospective observational study was conducted in the department of orthopedics at a tertiary-level care hospital in North India from April 2021 till March 2022. All consecutive patients above 18 years of age, with comminuted closed RHF, were included in the study. All underwent modular metallic head radial head implantation. The Mayo Elbow Performance Score (MEPS) was used to measure functional outcomes.

Results: We observed that MEPS at 1-month follow-up was 81.54 ± 11.18, which improved significantly at the 3rd-month follow-up to 87.24 ± 12.42 (P < 0.001). On the next follow-up at the 6th month, MEPS increased further to 92.14 ± 7.36, P < 0.001. At the final follow-up at the 6th month, MEPS was graded as excellent for 80%, good for 12%, fair for 4%, and poor for 4%. One patient had complex regional pain syndrome and one had joint stiffness.

Conclusion: The use of a modular radial head prosthesis has shown promise in treating comminuted RHF by re-establishing elbow joint stability in acute setting. This study demonstrated promising short-to-midterm results for the modular radial head arthroplasty.

Key words: Radial Head Fracture; Radial Head Arthroplasty; Radial Head Prosthesis






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