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Proximal radial drift following radial head resection
Alison Schiffern1, Stephen P Bettwieser, Christina A Porucznik
1Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT 84108, USA.
Journal of Shoulder and Elbow Surgery
|February 18, 2011
Summary
Radial head resection causes proximal radius stump migration medially and posteriorly. Resection exceeding 2 cm increases this drift, impacting elbow alignment and function.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Radiology
Background:
- Proximal radial migration is known after radial head resection.
- Previous studies have not assessed drift in all planes post-resection.
- Understanding radial stump positioning is crucial for elbow function.
Purpose of the Study:
- To evaluate the anatomic position of the radial stump relative to the capitellum after radial head resection.
- To identify factors influencing radial stump position.
- To determine the long-term functional outcomes associated with radial stump position.
Main Methods:
- Retrospective review of 13 patients undergoing radial head resection.
- Mean follow-up of 72 months.
- Assessment included physical examination, Disabilities of the Arm, Shoulder, and Hand (DASH), Mayo Elbow Performance Score (MEPS), Visual Analog Scales (VAS), and elbow radiographs (AP and lateral).
Main Results:
- Average resection length was 18 mm (range, 11.1-31.9 mm).
- Significant medial and posterior migration of the radial stump was observed compared to the contralateral side.
- Resection >2 cm correlated with increased posterior drift (P = .03).
- Poorer MEPS scores were associated with initial dislocation injury patterns (P = .02).
Conclusions:
- Radial head resection frequently results in posterior and medial drift of the proximal radial stump, leading to nonanatomic alignment with the capitellum.
- Resection length greater than 2 cm is associated with increased radial stump drift.
- Initial dislocation injury patterns are linked to worse functional outcomes.
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