ABSTRACT
This retrospective study aims to evaluate the radiographic, functional, and patient-derived outcomes of 16 patients who each received a Vitallium radial head prosthesis for unreconstructable acute fractures of the radial head, as well as previously treated fractures of the radial head associated with residual instability, pain, and stiffness. Follow-up averaged 33 months. A trend toward greater disability and poorer motion was noted in the delayed treatment group compared with the acute replacement group. Overall, the results were excellent in 5 patients, good in 10, and poor in 1, as determined by the Mayo Elbow Performance Score. All elbows were stable at follow-up, and no patient reported wrist pain. Four required further operative treatment of their elbow injuries. Metallic radial head arthroplasty yields satisfactory results in acute unreconstructable radial head fractures or as a salvage procedure for previously treated radial head fractures.
Subject(s)
Elbow Joint/surgery , Fractures, Bone/surgery , Joint Dislocations/surgery , Joint Prosthesis , Radius Fractures/surgery , Vitallium , Acute Disease , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Middle Aged , Prospective Studies , Prosthesis DesignSubject(s)
Bone Morphogenetic Proteins/therapeutic use , Pseudarthrosis/congenital , Pseudarthrosis/therapy , Recombinant Proteins/therapeutic use , Tibial Fractures/congenital , Tibial Fractures/therapy , Transforming Growth Factor beta/therapeutic use , Bone Morphogenetic Protein 7 , Child , Child, Preschool , Female , Fracture Fixation, Internal , Fracture Healing , Humans , Infant , Male , Prospective Studies , Pseudarthrosis/diagnostic imaging , Radiography , Tibial Fractures/diagnostic imaging , Treatment OutcomeABSTRACT
PURPOSE: Dorsal plating of distal radius fractures with titanium plates has resulted in clinically observed tenosynovitis and tendon rupture. The goal of this study was to investigate whether titanium-based implants result in more extensor tendon inflammation than matched stainless-steel implants in a canine fracture model. METHODS: An osteotomy was created in the distal radius of 18 beagles and fixed with 2.7-mm 4-hole plates composed of commercially pure titanium, titanium alloy (Ti-Al6-V4), or 316L stainless steel. Animals were killed at an average of 4 months. Tendon gliding was assessed by applying a force at the extensor musculotendinous junction and noting gliding. Histologic grading (mild, moderate, severe) was based on cellular hypertrophy, hyperplasia, and leukocytic infiltration. RESULTS: Tendons glided freely in 100% stainless-steel specimens, 75% of titanium alloy, and 43% of commercially pure titanium groups. A severe inflammatory reaction was identified in 60% of the titanium alloy (Ti-A16-V4) group, 57% of the pure titanium group, and 0% of the stainless-steel group. CONCLUSIONS: Dorsal plating of the canine radius with commercially pure titanium or titanium alloy implants produced a greater inflammatory peritendinous response than matched stainless-steel implants.
