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Reference points for radial head prosthesis size.

Job N Doornberg1, Durk S Linzel, David Zurakowski

  • 1Department of Orthopaedic Surgery and Biostatistics, Harvard Medical School, and Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA 02114, USA.

The Journal of Hand Surgery
|January 31, 2006
PubMed
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Proper placement of radial head prostheses is crucial to avoid joint overstuffing. Aligning the prosthesis with the lateral edge of the coronoid process provides a useful guideline for optimal radial head implant insertion.

Area of Science:

  • Orthopedic surgery
  • Biomechanical analysis
  • Medical imaging

Background:

  • Metallic radial head implants are vital for unreparable radial head fractures and elbow instability.
  • Overstuffing the radial head prosthesis can lead to capitellar erosion and ulnohumeral joint incongruity.

Purpose of the Study:

  • To determine optimal radial head prosthesis insertion using 3D CT analysis.
  • To establish reference points on the coronoid process for accurate implant height measurement.

Main Methods:

  • Quantitative 3D computed tomography (CT) analysis of 17 elbow scans.
  • Measurement of radial head height relative to the coronoid central ridge and lateral edge.
  • Determination of the anatomic coronal plane for standardized measurements.

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Main Results:

  • The radial head articular surface was, on average, -0.8 mm from the coronoid central ridge.
  • The radial head articular surface was, on average, -0.9 mm from the lateral edge of the coronoid.

Conclusions:

  • A general guideline is to align the radial head prosthesis plane with or slightly proximal to the lateral edge of the coronoid.
  • Preoperative radiographs of the contralateral elbow may aid in avoiding overstuffing due to anatomical variability.