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Radial head prostheses
There are two types of radial head prostheses, silastic and rigid. The former has been used for years for treatment of radius fractures. Among the newer designs, the Evolve (r) is the most popular. Other prostheses include the MoPyC (r) and Tornier's Iris. Both are designed for patients with a radial head fracture. The Evolve is the more flexible and less expensive option.
The Anatomic Radial Head is a radial head prosthesis that can be used for a variety of radial head fractures. The Acumed Anatomic Radial Hand has many features to help restore the natural length of the radius. The instrument also has a color-coded collar and components for easy assembly. The titanium stem is shaped to create a perpendicular Neck Surface. In the RAH, the Acumed Radial Head is designed to provide a stable attachment to the bone.
The Anatomical Radial Head is another type of radial head prosthesis. Its components include a stem and a lateral column. These two pieces need to be assembled during surgery to provide stability. The avulsion of the lateral complex may facilitate the approach to the radial joint. The surgeon can work around the lateral complex or perform a release followed by repair to restore stability. The placement of the radial head will restore the lateral stability. The surgeon should also develop a contingency plan in case residual instability occurs.
During the surgery, patients had a range of motion ranging from 107deg flexion-extension to 159deg pronosupination. The implant remained stable in all 25 cases and the authors describe the outcomes. During follow-up, mean pain scores were 89, whereas the DASH score was 1.8 for patients in the acute treatment group. The authors conclude that the Anatomic Radial Head System is safe and effective for resurfacing the facet of the skull.
The surgical procedure is simple and painless. The procedure involves making an incision at the side of the elbow. The surgeon carefully removes the broken fragments of the radial body and the neck. The prosthesis is fitted into the radial cavity. The surgeon tests the stability of the prosthesis and the stability of the patient during arm movements. The incision is then closed with a suture. The implant is now attached to the bone and stabilizes the radial torso.
In the first studies, a modular uncemented smooth-stem prosthesis was used for radial head replacement. The prosthesis consisted of a head segment and a stem with options for neck length and diameter. After sequential canal reaming and calcar trimming, a single-use stem was selected for the procedure. The Evolve is considered the best option for primary radial head replacement.