Effect of radial head malunion on radiocapitellar stability

Dave R. Shukla, James S. Fitzsimmons, Kai Nan An, Shawn W. O'Driscoll

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Management for Mason type II radial head fractures is controversial. We hypothesized that angulation or depression of a marginal radial head fragment would affect radiocapitellar stability similarly to fragment excision. Materials and methods: A Mason type II radial head fracture was created in 6 cadaveric elbows by excising a segment from the anterolateral quadrant that was 30% of the diameter of the articular surface. Radiocapitellar stability was recorded under 5 sets of conditions: (1) intact radial head (intact), (2) 30% surface area fragment resected (partially excised), (3) anatomic fragment fixation with screws (fixed), (4) fragment fixation with 2 mm of depression relative to the articular surface (depressed), and (5) fragment fixation after a 30° wedge resection (angulated). Results: The forces required to subluxate the joint were greatly reduced after fragment excision (5 ± 1 N; P = .0001) and restored to normal (21 ± 1 N; P = .9) after anatomic fixation of the excised fragment. The peak forces were significantly reduced with fragment depression (4 ± 1 N) and angulation (4 ± 2 N; P = .0001). Conclusion: A radial head fracture that is depressed 2 mm or angulated 30° may cause up to an 80% loss of concavity-compression stability of the radiocapitellar joint.

Original languageEnglish (US)
Pages (from-to)789-794
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume21
Issue number6
DOIs
StatePublished - Jun 1 2012

Keywords

  • Mason fracture classification
  • Radial head fracture
  • Radiocapitellar stability

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Shukla, D. R., Fitzsimmons, J. S., An, K. N., & O'Driscoll, S. W. (2012). Effect of radial head malunion on radiocapitellar stability. Journal of Shoulder and Elbow Surgery, 21(6), 789-794. https://doi.org/10.1016/j.jse.2011.12.001