Failure of a Unipolar Radial Head Prosthesis Due to Component Dissociation.

Radial head implant arthroplasty is a consideration for the treatment of comminuted, unreconstructable fractures of the radial head. Many prosthetic designs exist and can be unipolar or bipolar, each of which can be cemented or noncemented. For most unipolar designs, a prosthetic stem is first implanted into the proximal radius. The prosthetic radial head is then impacted onto a morse taper on the stem or secured with a set screw. There is little information published on the mechanisms of failure for radial head implants, regardless of design. The authors found 2 individual case reports that describe component dissociation in bipolar implants. They could find no individual case reports of implant failure due to component dissociation of a unipolar implant related to failure of the set screw. The authors describe such a case 5 years after unipolar radial head implant arthroplasty. The system used employs a set screw to secure the prosthetic head onto the stem. The patient subsequently had a successful outcome after implant removal without reimplantation. Orthopedic surgeons have many options when considering radial head replacement implants and should be aware of the potential complications of each. The authors present this case to show one potential complication of unipolar prosthetic radial head implant arthroplasty. [Orthopedics. 2016; 39(4):e771-e774.].

Metastatic esophageal adenocarcinoma of the carpus.

We report on a rare case of metastatic esophageal adenocarcinoma to the wrist developing years after diagnosis and treatment of the primary lesion. Awareness of the potential for developing these lesions should be raised, particularly in the absence of systemic symptoms.

Distal radioulnar allograft reconstruction after giant cell tumor resection.

Giant cell tumor of bone is considered to be a benign, locally aggressive lesion. When diagnosed early, it can be successfully treated with wide en bloc excision. No reports of complete distal radioulnar allograft reconstruction after en bloc excision of a distal ulnar lesion were found in the literature. We report a case of a distal ulnar giant cell tumor treated with wide en bloc excision and 2-stage allograft reconstruction and followed up for 40 months.

Flexor tendon rupture caused by gout: a case report.

We present a case of primary gouty infiltration of flexor tendons in the hand, causing rupture of both flexor digitorum superficialis and profundus tendons in a single digit. The patient was managed by a single-stage reconstruction of the less involved flexor digitorum superficialis tendon using a segment of the proximal stump of flexor digitorum profundus tendon as a bridge graft. This uncommon etiology of tendon rupture should be considered in all patients with a history of gout presenting with tendon insufficiency.