ArticleIndian journal of orthopaedics2020
Fracture Pattern Influences Radial Head Replacement Size Determination Among Experienced Elbow Surgeons.
Article in Indian journal of orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The role of radial head morphology in proximal radioulnar joint congruency during forearm rotation.Journal of experimental orthopaedics · 2024Article
- Radial head arthroplasty diameter impact on elbow kinematics evaluated by dynamic radiostereometric analysis.Journal of experimental orthopaedics · 2024Article
- Novel Radiographic Indexes for Elbow Stability Assessment: Part A-Cadaveric Validation.Indian journal of orthopaedics · 2021Article
- Novel Radiographic Indexes for Elbow Stability Assessment: Part B-Preliminary Clinical Study.Indian journal of orthopaedics · 2021Article
- Does Sawbone-Based Arthroscopy Module (SBAM) Can Help Elbow Surgeons?Indian journal of orthopaedics · 2021Article
- Validation of a Practical Forearm Supination Strength Measurement Technique in the Large Sample Cohort.Indian journal of orthopaedics · 2020Article
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10 authors.
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Abstract
backgroundCorrect sizing is challenging in radial head replacement and no consensus exists on the implant's optimal height and width to avoid elbow stiffness and instability. Studies exists, suggesting how to appropriately choose the implant size, but the manner by which the fracture pattern influences the surgeons' operative choices was not investigated.
methodsThe radial heads of four fresh-frozen cadaveric specimens were excised, measured, and fractured to simulate four patterns: three fragments (A); four fragments (B); comminuted (C); comminuted with bone loss (D). Nine examiners were asked to indicate first the maximum diameter of the radial heads with the help of dedicated sizing dishes and then the appropriate implant size with trial implants. Accuracy and precision were determined. A coefficient of variation was calculated and agreement was evaluated with the Bland-Altman method.
resultsAccuracy and precision of radial head diameter estimation with dedicated sizing dish were 96.73% and 93.64%, (best pattern, D; worst, C). Accuracy and precision of radial head diameter estimation with trial implants were 99.71% and 90.66% (best pattern, A; worst, D). Frequent modifications occurred between the initial radial head size proposal based on the sizing dish and the radial head size chosen after use of the trial implants (47.2%).
conclusionsDiameter estimation of radial heads with dedicated sizing dishes may be underestimated in comminuted fractures; when bone loss is present, this may lead to an overestimation, especially when using trial implants. Care is essential to determine the optimal size of the implant and to avoid overlenghtening and oversizing, which can be responsible for implant failure. LEVEL OF EVIDENCE: Basic Science Study. CLINICAL RELEVANCE: Knowledge of the manner by which the fracture pattern influences radial head replacement size estimation can help preventing overlenghtening and oversizing during this procedure.
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