This paper is only available as a PDF. To read, Please Download here.
Five patients with disabling symptoms related to proximal translation (>1 cm) of the
radius following radial head excision (Essex-Lopresti lesion) were treated with implantation
of a frozen-allograft radial head prosthesis. Following restoration of neutral ulnar
variance at the wrist, a size-matched frozen radial head allograft was implanted and
secured to the proximal radius with internal fixation. In three patients, this was
a two-stage procedure; radial length was restored gradually using an Ilizarov external
fixation device and the allograft was placed later. Patients were evaluated clinically
and radiographically at a mean follow-up time of 3 years (range, 1–7 years). All patients
had relief of wrist and elbow pain and were satisfied with the outcome of the operation.
Forearm rotation improved by a mean of 37° and wrist motion improved by a mean of
45°. Forearm reconstruction with frozen radial head allograft implantation may be
a beneficial method of treatment for this difficult problem.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Two cases of disability at the wrist joint following excision of the head of the radius.Proc R Soc Med. 1930; 24: 904-905
- Radial head fracture: a potentially complex injury.Clin Orthop. 1993; 297: 224-230
- Radial head fracture with acute distal radioulnar dislocation: Essex-Lopresti revisited.Clin Orthop. 1988; 234: 61-69
- Fractures of the radial head with distal radial-ulnar dislocations.J Bone Joint Surg. 1951; 33B: 244-247
- Deformity of the wrist following resection of the radial head.Surg Gynecol Obstet. 1937; 64: 1079-1085
- Subluxation of the inferior radioulnar joint complicating fracture of the radial head.J Bone J Surg. 1957; 39B: 278-286
- Pathomechanics of proximal migration of the radius: an anatomic and mechanical study of the interosseous membrane of the forearm.J Hand Surg. 1989; 14A: 256-261
- The role of the interosseous membrane and triangular fibrocartilage complex in forearm stability.J Hand Surg. 1994; 19A: 385-393
- Dislocation of the inferior radio-ulnar joint.Br J Surg. 1946; 34: 74-77
- Injuries to the interosseous ligament of the forearm.Hand Clin. 1994; 10: 391-398
- The effect upon the inferior radioulnar joint of excision of the head of the radius in adults.J Bone Joint Surg. 1964; 46B: 83-88
- Symptomatic proximal translation of the radius following radial head resection.Clin Orthop. 1995; 317: 106-113
- Radio-ulnar dissociation: a review of twenty cases.J Bone Joint Surg. 1992; 74A: 1486-1497
- Immune response inhibition by irrigating subchondral bone with cytotoxic agents.Clin Orthop. 1996; 326: 96-106
- Transmission of disease through transplantation of musculoskeletal allografts.J Bone Joint Surg. 1995; 77A: 1742-1754
- Resection of the radial head for fracture of the radial head.J Bone Joint Surg. 1987; 69A: 385-392
- Reactive synovitis from particulate silastic.J Bone Joint Surg. 1982; 64A: 581-584
- Biomechanical study of the elbow following excision of the radial head.J Bone Surg. 1979; 61A: 63-68
- Fracture of a silastic radial-head prosthesis: diagnosis and localization of fragments by xerography.J Bone Joint Surg. 1981; 63A: 1482-1483
- Synovial and osseous inflammation in failed silicone-rubber prosthesis.J Bone Joint Surg. 1982; 64A: 574-580
- Fractures of Silastic radial-head prosthesis.J Bone Joint Surg. 1981; 63A: 459-460
- Primary replacement of the fractured radial head with a metal prosthesis.J Bone Joint Surg. 1993; 75B: 572-576
- Clinical results of the one-bone forearm.J Hand Surg. 1995; 20A: 609-618
- Allograft replacement with distal radioulnar joint fusion and ulnar osteotomy for treatment of giant cell tumors of the distal radius.J Hand Surg. 1990; 15A: 929-933
- HIV infection of human cartilage.J Bone Joint Surg. 1996; 78B: 22-25
- Bone transplantation and human immunodeficiency virus: an estimate of risk of acquired immunodeficiency syndrome (AIDS).Clin Orthop. 1989; 240: 129-136
Article info
Publication history
Accepted:
September 26,
1996
Received:
December 8,
1995
Footnotes
*The author or one or more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 1997 The American Society for Surgery of the Hand. All rights reserved. Published by Elsevier Inc.
