Morrey BF: Radial head fracture. The elbow and its disorders, 3rd ed,Morrey BF, ed. Philadeiphia, WB Saunders, 2000, p341-364.
Mezera K, Hothchikiss RN: Radial head fractures. Rockwood and Green’s Fractures in Adults, 5th ed, Bucholz RW, HeckmanJD,eds. Lippincott Williams & Wilkins, Philadelphia, 2001, p940-952.
Ring D: Radial head fractures. Rockwood and Green’s Fractures in Adults, 6th ed, Bucholz RW, et al, eds. Lippincott Williams & Wilkins, Philadelphia, 2006, p1010-1019.
井上五郎:橈骨中枢端骨折.新図説臨床整形外科講座5肩・上腕・肘. メジカルビュー,1994,p276-283.
澤泉卓哉,南野光彦:肘関節脱臼・骨折治療のマニュアル.橈骨頭・頚部骨折.Monthly Book Orthopaedics 2008;21(7):65-71..
私の手の外科改訂第3版. 南光堂、1995;18.
Morrey BF: Radial head fracture. In Lampert R (Morrey BF), ed. The elbow and its disorders, 3rd ed. Philadeiphia, WB Saunders, 2000;341-364.
W Regan, B Morrey
Fractures of the coronoid process of the ulna.
J Bone Joint Surg Am. 1989 Oct;71(9):1348-54.
Abstract/Text
A review of thirty-five patients who had a fracture of the coronoid process of the ulna revealed three types of fracture: Type I--avulsion of the tip of the process; Type II--a fragment involving 50 per cent of the process, or less; and Type III--a fragment involving more than 50 per cent of the process. A concurrent dislocation or associated fracture was present in 14, 56, and 80 per cent of these patients, respectively. The outcome correlated well with the type of fracture. According to an objective elbow-performance index used to assess the results for the thirty-two patients who had at least one year of follow-up (mean, fifty months), 92 per cent of the patients who had a Type-I fracture, 73 per cent who had a Type-II fracture, and 20 per cent who had a Type-III fracture had a satisfactory result. Residual stiffness of the joint was most often present in patients who had a Type-III fracture. We recommend early motion within three weeks after injury for patients who have a Type-I or Type-II fracture. Reduction and fixation, followed by early motion when possible, may be the preferred treatment for patients who have a Type-III fracture.
南野光彦,澤泉卓哉,伊藤博元:橈骨頭骨折 その最新手技.関節内骨折の手術−その最新手技.新OS NOW新世代の整形外科手術Vol. 18:東京,メディカルビュー,54-59,2003..
T K TAYLOR, B T O'CONNOR
THE EFFECT UPON THE INFERIOR RADIO-ULNAR JOINT OF EXCISION OF THE HEAD OF THE RADIUS IN ADULTS.
J Bone Joint Surg Br. 1964 Feb;46:83-8.
Abstract/Text
南野光彦,白井康正,澤泉卓哉,橋口 宏,今野俊介:橈骨頭骨折の治療経験.骨折 2001;23:236-239..
南野光彦,澤泉卓哉,橋口 宏,中原義人,六郷知行,伊藤博元:肘関節脱臼を伴った橈骨頭および橈骨頸部骨折の治療経験.骨折 2003;25:733-736..
南野光彦,澤泉卓哉,伊藤博元:橈骨頭骨折 その最新手技.関節内骨折の手術−その最新手技.新OS NOW新世代の整形外科手術Vol. 18. メジカルビュー,2003;54-59..
南野光彦,澤泉卓哉,南部昭彦,小寺訓江,伊藤博元:橈骨頭粉砕骨折に対するlow-profile plate systemの治療経験.日本肘関節研究会誌 2004;11:107-108..
南野光彦,澤泉卓哉,高井信朗:成人橈骨頭,頸部骨折の治療成績の検討.骨折34:p S58,2012..
Nanno M, Shirai Y,Sawaizumi T, AokiT, Hashiguchi H, Kodera N : Surgical treatment of radial head and neck fractures. J. Jpn. Elb. Soc., 7: 141-142, 2000.
P ESSEX-LOPRESTI
Fractures of the radial head with distal radio-ulnar dislocation; report of two cases.
J Bone Joint Surg Br. 1951 May;33B(2):244-7.
Abstract/Text
King JC: Radial head fracture. Wrist and elbow reconstruction & arthroscopy, A master skills publication. Trumble TE, ed. Rosemont, American Society for Surgery of the Hand, 2006, P463-488.
橋口 隆ほか:肘関節脱臼骨折の治療成績.骨折 1995;17:597-600..
Jeffrey M Pike, George S Athwal, Kenneth J Faber, Graham J W King
Radial head fractures--an update.
J Hand Surg Am. 2009 Mar;34(3):557-65. doi: 10.1016/j.jhsa.2008.12.024.
Abstract/Text
Radial head fractures are the most common fractures occurring around the elbow. Although radial head fractures can occur in isolation, associated fractures and ligament injuries are common. Assembling the clinical presentation, physical examination, and imaging into an effective treatment plan can be challenging. The characteristics of the radial head fracture influence the technique used to optimize the outcome. Fragment number, displacement, impaction, and bone quality are considered when deciding between early motion, fragment excision, and radial head excision, repair, or replacement. Isolated, minimally displaced fractures without evidence of mechanical block can be treated nonsurgically with early active range of motion (ROM). Partial, displaced radial head fractures without evidence of mechanical block can be treated either nonsurgically or with open reduction internal fixation (ORIF), as current evidence does not prove superiority of either strategy. For displaced fractures with greater than 3 fragments, radial head replacement is recommended. Radial head arthroplasty may be preferred over tenuous fracture fixation in the setting of associated ligament injuries when maintenance of joint stability could be compromised by ineffective fracture fixation.
T Judet, C Garreau de Loubresse, P Piriou, G Charnley
A floating prosthesis for radial-head fractures.
J Bone Joint Surg Br. 1996 Mar;78(2):244-9.
Abstract/Text
We report our experience over seven years with a floating radial-head prosthesis for acute fractures of the radial head and the complications which may result from such injury. The prosthesis has an integrated articulation which allows change of position during movement of the elbow. We present the results in 12 patients with a minimum follow-up of two years. Five prostheses had been implanted shortly after injury with an average follow-up of 49 months and seven for the treatment of sequelae with an average follow-up of 43 months. All prostheses have performed well with an improved functional score (modified from Broberg and Morrey 1986). We have not experienced any of the complications previously reported with silicone radial-head replacement. Our initial results suggest that the prosthesis may be suitable for the early or delayed treatment of Mason type-III fractures and more complex injuries involving the radial head.
I J Harrington, A Sekyi-Otu, T W Barrington, D C Evans, V Tuli
The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review.
J Trauma. 2001 Jan;50(1):46-52.
Abstract/Text
BACKGROUND: A long-term review of metal prosthetic radial head replacement in patients with radial head fractures associated with gross instability of the elbow has been performed.
METHOD: Twenty patients were reviewed using a modified Mayo Clinic functional rating index system. The mean follow-up was 12.1 years, with a range from 6 to 29 years.
RESULTS: Results were excellent in 12 patients, good in 4 patients, fair in 2 patients, and poor in 2 patients. A metal radial head replacement restored elbow stability when fracture of the radial head occurred in combination with dislocation of the elbow, rupture of the medial collateral ligament, fracture of the proximal ulna, and/or fracture of the coronoid process.
CONCLUSION: We conclude that a metal radial head prosthesis has select indications. We advocate its use when the radial head cannot be reconstructed in the setting of a clinically unstable elbow. Results suggest that it functions well on a long-term basis.
N Popovic, P Gillet, A Rodriguez, R Lemaire
Fracture of the radial head with associated elbow dislocation: results of treatment using a floating radial head prosthesis.
J Orthop Trauma. 2000 Mar-Apr;14(3):171-7.
Abstract/Text
OBJECTIVES: To assess elbow function, complications, and problems of radial head fractures associated with elbow dislocation receiving surgical treatment with a floating prosthesis.
DESIGN: Prospective clinical study.
SETTING: University Hospital, Orthopaedic Department, Sart Tilman, Liège, Belgium.
PATIENTS: Eleven consecutive adult patients were treated with a floating prosthesis for acute radial head fractures associated with elbow dislocation from January 1994 to September 1996.
INTERVENTION: The floating radial head prosthesis (Tornier SA, Saint-Ismier, France) was used in all our patients. The implant is in two parts: a radial head made of high-density polyethylene enclosed in a cobalt-chrome cup, which articulates in a semiconstrained manner with the spherical end of a cemented intramedullary stem. The implants were inserted within the first week following the injury (range 2 to 7 days). Three cases also required internal fixation of the coronoid process of the ulna; in one case plate fixation of an olecranon fracture was also performed.
MAIN OUTCOME MEASUREMENTS: Patients were assessed by physical examination, a functional rating index (Morrey et al.), and radiographs. The parameters evaluated were motion, stability, pain, and grip strength. Potential complications such as infection, prosthetic failure, or dislocation were investigated.
RESULTS: The minimum follow-up time was two years (mean 32 months, range 24 to 56 months). Four patients were considered to have excellent results, four patients were considered to have good results, two patients had fair results, and one patient had a poor result. There were no cases of infection, prosthetic failure, or dislocation. No patient required prosthetic revision.
CONCLUSION: The basic principle of maintaining anatomic and physiologic relationships applies when deciding on treatment for radial head fractures with associated elbow dislocation. The loss of lateral osseous support will render the elbow grossly unstable. We believe that a floating prosthesis may be indicated in Mason Type III radial head fractures associated with elbow dislocation, especially in the presence of associated destabilizing fractures. Well-controlled comparative randomized studies will be needed to delineate the optimal treatment for a given situation.
Nebojsa Popovic, Roger Lemaire, Pierre Georis, Philippe Gillet
Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface.
J Bone Joint Surg Am. 2007 Nov;89(11):2469-76. doi: 10.2106/JBJS.F.00723.
Abstract/Text
BACKGROUND: Metal prostheses are useful for restoring elbow and forearm stability when the radial head cannot be fixed after a fracture. Because the anatomy of the radial head is difficult to reproduce with a prosthesis, two different options have been proposed: a bipolar prosthesis with a fixed stem and a mobile head, and a monoblock prosthesis with a smooth stem that is intentionally fixed loosely in the neck of the radius. One concern with a fixed-stem implant with a mobile head has been the risk of osteolysis. The purpose of this study was to evaluate radiographic changes reflecting or suggesting progressive osteolysis in patients with a bipolar radial head prosthesis.
METHODS: The functional and radiographic outcomes following treatment of fifty-one comminuted fractures of the radial head with a bipolar radial head prosthesis in fifty-one consecutive patients were evaluated at a mean of 8.4 years postoperatively. There were eleven isolated comminuted fractures involving the entire radial head. Thirty-four fractures were associated with a posterior elbow dislocation, and six patients had a posterior Monteggia lesion.
RESULTS: According to the Mayo Elbow Performance Index, fourteen elbows were graded as excellent; twenty-five, as good; nine, as fair; and three, as poor. Radiographic changes reflecting or suggesting progressive osteolysis were present in thirty-seven patients. Complications occurred in ten patients, but only one underwent surgical treatment, for an ulnar neuropathy.
CONCLUSIONS: Although satisfactory midterm functional results were achieved in thirty-nine of the fifty-one patients, the high prevalence of adverse radiographic changes suggesting periprosthetic osteolysis should alert clinicians to this possible drawback of the use of bipolar radial head prostheses, especially in young and/or active patients.
吉川泰之,池上博泰,西脇正夫,田崎憲一,佐藤和毅,牧田聡夫:橈骨頭新鮮骨折例に対するJudet人工橈骨頭の治療成績.日肘会誌 2003;10:165-166..
P I O'Brien
Injuries involving the proximal radial epiphysis.
Clin Orthop Relat Res. 1965 Jul-Aug;41:51-8.
Abstract/Text
三枝憲成,難波健二,伊藤恵康ほか:橈骨頚部骨折の治療.整形外科 1987;38:1527-1537..
J P Metaizeau, P Lascombes, J L Lemelle, D Finlayson, J Prevot
Reduction and fixation of displaced radial neck fractures by closed intramedullary pinning.
J Pediatr Orthop. 1993 May-Jun;13(3):355-60.
Abstract/Text
Radial neck fractures in children are serious injuries with frequent sequelae when the tilt exceeds 60 degrees. Conservative treatment is often inadequate in such cases and open reduction may produce iatrogenic complications. We report our experience with an original technique. An intramedullary wire introduced from below and projected upward allows reduction of the displacement and maintenance of the correction without infringing the joint. The operative technique is described. This method was used in 31 fractures with between 30 degrees and 80 degrees of tilt and in 16 fractures with > 80 degrees of tilt. Excellent and good functional results were obtained in 30 cases in the first group and in 11 cases in the second group.
G R Smith, R N Hotchkiss
Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation.
J Shoulder Elbow Surg. 1996 Mar-Apr;5(2 Pt 1):113-7.
Abstract/Text
A cadaveric study of the radial head and neck was performed to determine the anterior and posterior limits for safe placement of internal fixation on the surface of the radial head or neck. A "safe zone" of approximately 110 degrees of radial head surface was first identified by cross-sectional anatomic dissections. This "safe zone" was then reproducibly confirmed relative to forearm position when viewed from a standard lateral approach. Because the proximal radioulnar joint cannot be directly visualized through the standard lateral approach, the zone was indirectly identified by making reference marks along the radial head and neck. To determine the position of the "safe zone" reference marks are first made along radial head and neck so as to bisect the bone's anteroposterior distance. Three such marks are made with the forearm in neutral rotation, full supination, and full pronation. Next, the posterior limit of the zone is determined by bisecting the reference marks made with the forearm in neutral rotation and full pronation. The anterior limit is determined by going nearly two thirds of the distance from the neutral mark to that mark made in full supination.
R L Linscheid, D K Wheeler
Elbow dislocations.
JAMA. 1965 Dec 13;194(11):1171-6.
Abstract/Text
石井清一ほか: 日本整形外科学会肘機能評価法.日整会誌1992;66:591-603..
南野光彦,澤泉卓哉,小寺訓江,友利裕二,堀口 元,高井信朗:成人橈骨頭・頚部骨折の治療成績の検討.骨折 2013;35:36-39.
石井清一ほか: 日本整形外科学会肘機能評価法.日整会誌 1992;66:591-603..
Nanno M,Shirai Y,Ito H, Sawaizumi T, Hashiguchi H: Percutaneous pinning for radial neck fractures. J. Jpn. Elbow Soc., 8: 109-110, 2001.
整形外科医のための手術解剖学図説. 南江堂,1986;98,図3-31.