Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: Good outcome after 1–4 years follow-up in 11 patients

Figures & data

Figure 1. The Judet CRF II bipolar radial head prosthesis.Head and stem sizes are interchangeable.

Table 1.  Mason Johnston classification of radial head fractures

I	Non-displaced
II	Minimally displaced with depression, angulation and impaction
III	Comminuted and displaced
IV	Radial head fractures associated with dislocation of the elbow

Table 2.  Pre-operative details and details at follow-up of the 11 patients in this series treated with radial head replacement

A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	V	W	X	Y	Z
1	F	48	R–	IV	1	1	*	4/8	N	1	Y	N	*	*/*	1,4	1,2	12	N	0/1	N	0	0	140/10/0	E/G	–
2	M	26	R+	III	2,3	2,3	*	*	Y	2	N	Y	*	*/*	0,6	1,3	12	Y	0/2	N	0	0	130/10/0	G/G	^a
														minor									70/0/70
3	M	38	R+	III	–	2	1,2	?/?	Y	2	N	N	140/0/0	G/F	30	1,4	48	N	2/3	N	0	0	145/5/0	G/G	–
													70/0/0										70/0/90
4	M	56	L−	III	–	2	2	0/0	Y	2	N	N	140/5/0	F/F	3,4	1	12	N	0/0	N	0	0	150/10/0	E/E	–
													45/0/0										70/0/50
5	M	37	L−	IV	1	2	2	?/?	Y	2	N	N	90/60/0	F/F	12	1	48	N	0/2	N	0	0	100/30/0	G/G	^a
													20/0/0										50/0/50
6	M	57	R+	III	–	3	1,2	2/5	Y	0	N	Y	130/35/0	G/F	24	1	24	N	0/5	N	1	0	120/20/0	G/G	–
													60/0/0										50/0/60
7	M	44	R+	III	–	3	1	0/2	Y	0	N	Y	140/0/0	E/E	18	1	30	N	0/3	N	0	0	140/0/0	E/G	^b
													80/0/70										80/0/70
8	M	29	R+	III	–	2,3	1,3	2/6	Y	0	N	Y	130/15/0	G/G	32	1	12	N	0/1	N	0	0	140/10/0	E/G	–
													80/0/70										80/0/70
9	F	33	R−	IV	1	3	1,3,4	3/8	Y	2	N	N	140/5/0	F/P	188	1,4	12	N	0/2	N	1	0	140/20/0	G/E	–
													50/0/80										80/0/80
10	F	57	L−	III	–	3	1,3,4	3/8	Y	3	N	N	110/10/0	G/F	335	1,4	13	N	0/4	N	0	0	140/5/0	E/G	–
													80/0/70										80/0/45
11	M	61	R+	III	–	3	2,3,4	0/4	N	2	Y	N	130/20/0	G/G	379	1	25	N	0/4	N	1	0	140/40/0	E/E	^c
													50/0/50										80/0/70

• A Patient

• B Sex

• C Age

• D Side operated on

  • + Dominant arm

  • − Non-dominant arm

• E Fracture type according to Mason-Johnston classification (I to IV, see Table 1)

• F Associated injury

  • 1 Elbow luxation

  • 2 Essex Lopresti lesion

  • 3 Ulna fracture

• G Previous treatment

  • 1 K-wire fixation

  • 2 ORIF

  • 3 Radial head resection

• H Main complaint patient

  • 1 Wrist pain

  • 2 Limited ROM

  • 3 Elbow pain

  • 4 Instability

• I Pain VAS score at rest/on activity

• J Presence of rotatory instability

• K Presence of MCL instability

  • 0 No instability

  • 1 Mild

  • 2 Moderate

  • 3 Severe

• L Presence of LCL instability

• M Presence of proximal radial migration

• N Range of motion on flexion/extension

• O Preoperative EFA/Andrews score

  • E Excellent

  • G Good

  • F Fair

  • P Poor

• P Time from injury to radial head replacement in months

• Q Treatment

  • 1 Radial head replacement

  • 2 LCL repair

  • 3 DRUL repair

  • 4 MCL repair

• R Follow-up in months

• S Wrist complaints at follow-up

• T Pain VAS score at rest/on activity at follow-up

• U Rotatory instability at follow-up

• V MCL instability at follow-up (see K)

• W LCL instability at follow-up

• X Range of motion at follow up

• Y EFA/Andrews score at follow-up (see O)

• Z Complications and treatment

  • a Limited ROM, mobilisation under anesthesia

  • b Subluxation/instability, head replacement and annular ligament repair

  • c Subluxation and limited ROM, head replacement

  • * not available

  • ? not known

Figure 2. Lateral radiograph of the bipolar radial head prosthesis: case 1 at 12-month follow-up. Note the anchor used in the LCL repair.

Figure 3. Lateral radiograph of case 7 showing erosion of the capitellum; approximately one-third of the capitellum has been eroded by the prosthesis. The patient had no complaints related to the erosion.