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Related Experiment Videos

Silicone rubber distal ulnar replacement arthroplasty.

S D Sagerman1, J G Seiler, L L Fleming

  • 1Emory University School of Medicine, Department of Orthopaedics, Atlanta, Georgia.

Journal of Hand Surgery (Edinburgh, Scotland)
|December 1, 1992
PubMed
Summary

Silicone ulnar head prostheses often fail, with 63% showing migration or breakage. Functional outcomes were not linked to prosthesis integrity, suggesting these implants are not recommended after distal ulna resection.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Radiology

Background:

  • Distal ulna resection necessitates reconstruction to maintain wrist function.
  • Silicone rubber prostheses have been used to replace the resected ulnar head.

Purpose of the Study:

  • To evaluate the long-term outcomes and integrity of silicone rubber ulnar head prostheses after distal ulna resection.

Main Methods:

  • Retrospective review of 42 patients (45 wrists) who received silicone ulnar head prostheses (Swanson and custom designs).
  • Follow-up included X-rays to assess prosthesis integrity and clinical assessment of functional outcomes and range of motion.
  • Histological analysis was performed in cases requiring implant removal.

Main Results:

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  • 63% of prostheses exhibited migration or breakage on follow-up X-rays.
  • No significant correlation was found between prosthesis integrity and functional outcome.
  • No significant difference in pre-operative versus post-operative range of motion was observed, regardless of prosthesis condition.
  • One case of silicone synovitis requiring implant removal was histologically confirmed.

Conclusions:

  • Silicone ulnar head prostheses demonstrate high rates of failure (migration/breakage) due to fatigue.
  • Prosthesis integrity does not appear to influence functional outcomes or range of motion.
  • The use of silicone rubber ulnar head prostheses following distal ulna resection is not recommended.