[Prosthesis of the head of the radius in long-term follow-up--vitallium versus silastic]

At the Graz Hospital for Accident Surgery, seven Vitallium prostheses were implanted in the period from 1964 to 1968, and nine Silastic prostheses in the period from 1984 to 1991. In January 1993 we were able to do control examinations in eleven patients. Five of them with fractures of type B2.3, five of B3.3 and one of C3.3 according to the AO-Classification. Secondary treatment was done in four patients by prosthetic substitution. All patients had to wear a cast postoperatively for two to eight weeks. Our results--like those already described in relevant literature--clearly confirm the markedly poorere outcome of secondary treatment by prosthetic substitution of the head of the radius. On the basis of our results we therefore recommend in all cases where resection seems to be unavoidable to perform primary atraumatic resection with complete removal of all bone splinters and subsequent prosthetic substitution of the head of radius, if it is not possible to an osteoynthetic operation without immobilisation. We did not find any correlation to the classivication of the fracture types.