48-255

Prótesis de pirocarbono en fracturas complejas de cabeza de radio.

Pyrocarbon prosthesis in complex radial head fractures.

J. BALLESTER PARRA, V. ZARZUELA SÁNCHEZ, V. ESTREMS DÍAZ, J. RIBAS GARCÍA-PEÑUELA, L. HERNÁNDEZ FERRANDO, A. BRU POMER. SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA, CONSORCIO HOSPITAL GENERAL DE VALENCIA
Recepción:
18/02/2014
Aceptación:
18/02/2014
Publicación:
19/02/2014


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Resumen (ES)

The authors present the results of a retrospective observational study of 23 cases of a complex radial head fractures treated by pyrocarbon radial head prosthesis (MoPyc). This modular radial head prosthesis is composed of a cementless titanium stem and a 15º angulated neck. The gender distribution was 10 men and 13 women, average age 54 years. The mean follow-up was 70 months (48–93 months). The main etiology was a radial head fracture with elbow instability. Clinical evaluation was performed using the Mayo Elbow Performance Score (MEPS). Was assessed radiographically joint congruity, the size of the prosthesis, periprosthetic radiolucency, heterotopic ossification
and osteoarthritis. At follow-up, the MEPS average was 82/100, with 84% of good and excellent results. Elbow flexion averaged 130º, extension -30º, pronation 76º and supination 77º. Elbow stability was good in all the cases, and no proximal migration of the radius occurred. Asymptomatic bone lucencies were found in five cases around the stem. Complications included paresis of the posterior interosseous nerve with functional recovery after 11 weeks, 2 patients had “overstuffing” associated with posterior subluxation and they need to perform excision of the head and one heterotopic ossification with articular impact on balance that needs two surgeries, all of them with acceptable clinical results. The preliminary results are encouraging.

Palabras clave (ES):

Fractura
Codo
Fractura compleja
Artroplastia
Pirocarbono
Prótesis
Cabeza de radio conminuta

Resumen (EN)

The authors present the results of a retrospective observational study of 23 cases of a complex radial head fractures treated by pyrocarbon radial head prosthesis (MoPyc). This modular radial head prosthesis is composed of a cementless titanium stem and a 15º angulated neck. The gender distribution was 10 men and 13 women, average age 54 years. The mean follow-up was 70 months (48–93 months). The main etiology was a radial head fracture with elbow instability. Clinical evaluation was performed using the Mayo Elbow Performance Score (MEPS). Was assessed radiographically joint congruity, the size of the prosthesis, periprosthetic radiolucency, heterotopic ossification
and osteoarthritis. At follow-up, the MEPS average was 82/100, with 84% of good and excellent results. Elbow flexion averaged 130º, extension -30º, pronation 76º and supination 77º. Elbow stability was good in all the cases, and no proximal migration of the radius occurred. Asymptomatic bone lucencies were found in five cases around the stem. Complications included paresis of the posterior interosseous nerve with functional recovery after 11 weeks, 2 patients had “overstuffing” associated with posterior subluxation and they need to perform excision of the head and one heterotopic ossification with articular impact on balance that needs two surgeries, all of them with acceptable clinical results. The preliminary results are encouraging.

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