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Is a silastic radial head still a reasonable option?
Yariv Maghen1, Andrew J Leo, Jennifer W Hsu
1Department of Orthopaedic Surgery, The Mount Sinai School of Medicine, 5 East 98th Street, Box 1188, New York, NY 10029, USA.
Clinical Orthopaedics and Related Research
|November 20, 2010
Summary
Silastic radial head implants can be safely used in elbow fracture treatment when combined with ligament repair, showing low complication rates and no silicone synovitis. This approach improves elbow function and stability, offering a viable alternative for complex fractures.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- Radial head fractures often require intervention beyond simple repair.
- Silastic radial head arthroplasty has faced criticism due to concerns of silicone synovitis.
- Metal prostheses also present issues like overstuffing and cartilage wear, leaving treatment options controversial.
Purpose of the Study:
- To evaluate the efficacy of silastic radial head implants in conjunction with primary elbow stabilizer repair or reconstruction.
- To determine if this combined approach prevents implant fragmentation, failure, and silicone synovitis.
Main Methods:
- Retrospective review of 23 patients with unreconstructable radial head fractures treated with silastic arthroplasty and concomitant ligament repair.
- Assessment included range of motion, pain, stability, DASH scores, and MEPS.
- Minimum follow-up of 16 months (average 69.6 months).
Main Results:
- Patients achieved good functional outcomes with mean elbow flexion of 145°, extension 11°, supination 80°, and pronation 83°.
- Mean MEPS score was 88.9 and mean DASH score was 11.8.
- Eight reoperations were performed, none due to radial head implant failure.
Conclusions:
- Silastic radial head implants can be utilized with low complication rates when combined with concurrent elbow ligament repair or reconstruction.
- This approach effectively prevents implant failure and silicone synovitis, offering a reliable treatment for complex radial head fractures.
