Partial radial head arthroplasty jses international. Odriscoll, md, phd, the acumed anatomic radial head solutions 2 system includes 924 head and stem combinations and systemspecific instrumentation to help streamline the surgeons experience in the operating room. May 29, 20 the anatomic radial head system from acumed is indicated for radial head replacement after comminuted fracture. The acumed anatomic radial head system includes the first anatomically shaped radial head prosthesis introduced to the orthopaedic acjmed. Radial nerve palsy in fracture shaft of humerus mahe. The assessment of these common fractures and treatment have evolved with better understanding of the anatomy and biomechanics of radial head and the development of evidence based guidelines. Methods over a four year period, 15 patients average age 49. Radial head prosthesis surgical technique depuy synthes 1 2 resect radial head if the radial head is fractured and is not repairable, remove the fragments to ensure no bone is left in the joint. The system allows over 200 combinations of implants. It has a long and winding course rendering it vulnerable to injury. Open surgical release of posttraumatic elbow contracture.
The acumed anatomic radial head solutions 2 system is designed to provide an anatomic implant to replace the patients native radial head. The first radial head replacement system with colorcoded. Registering with the acumed sight is free and they offer streaming video surgical techniques. Ligaments about the radial head provide important soft tissue support and are essential to elbow stability after. Anatomic radial head system surgical technique acumed. Smooth stem implant designs supported by two long term studies 12year 1 and 8year 2 mean follow up modular stem and head design provides 324 size combinations. The acumed anatomic radial head system is designed to provide an 2 mini and micro instruments and the locking radial head plate system at the base of. Ninetythree patients with ulnar abutment syndrome underwent ulnar shortening osteotomy with the low profile osteotomy plate. Request pdf comminuted radial head fractures treated by the acumed anatomic radial head system the treatment of comminuted radial head fractures is still challenging. In adults, the radial head is wider than the radial neck. The radial head resection guide has two resection levels. Radial head fracture fragments were removed and used to determine the diameter of the radial head prosthesis needed. Using a microsagittal saw, resect any remaining radial head at the level of the radial neck, perpendicular to the axis of the neck figures 1 and 2.
The head and stem can be assembled insitu allowing for preservation of the radial collateral ligament. This type of fracture can occur from an elbow dislocation or it may just happen from a force, such as a fall to the outstretched arm. Listing a study does not mean it has been evaluated by the u. Comparison between radial head replacement and open reduction. Odriscoll, md, phd, the slideloc anatomic radial head system utilizes an innovative approach to sideloading radial head prostheses. Radial head fractures are the most common bony injury to the adult elbow. If you need help accessing information in different file. The acumed anatomic radial head system is designed to provide an anatomic implant to replace the patients native radial head. The radial head is clearly not round but has a more ellipsoidal shape.
Resecting the radial head radial head resection guide. The screw trajectory is designed to allow screws to capture fracture platlng and avoid other screws regardless of the screw length selected. While the average length of time of disability following these injuries is 8. With the anatomic radial head system,the surgeon is equipped with the tools needed to properly restore the patients anato. Anatomic radial head aculoc distal radius plates polarus proximal humerous plate mayo elbow plates calcaneal plate system foot and ankle plates fibula rod system. The management of mason ii fractures has evolved over the years 7, and remains controversial 14,19,20 as there is no consensus on optimal treatment 4. The slideloc head and neck assembly slides onto the stem and rotates in situ into alignment. Comminuted radial head fractures treated by the acumed. The objective of this study was to compare replacement of the radial head by metal prostheses with open reduction and internal fixation orif for the treatment of unstable, multifragmented radial head fractures. The design of the aculoc 2 plate positioning handle maintains access to the kwire holes and 3. For primary and revision joint replacement of the radial head. Anatomic radial head system cambridge orthopaedics.
The slideloc anatomic radial head system features a further refined anatomic radial head and a threepart implant design for increased modularity. Prior templating of the xray will also assist in determining which. Acumed releases the slideloc anatomic radial head system. Radial head fractures with acumed anatomic radial head system 6331 int j clin exp med 2015. The lateral column plates improve upon the biomechanics of posterior plating by enabling longer screws in the articular fragments to interdigitate with. The acumed anatomic radial head system is designed to provide an 2 mini and micro instruments and the locking radial. Radial head arthroplasty rha is predominantly used to treat comminuted radial head fractures and other, less common, chronic posttraumatic sequels as. Results all patients treated by the acumed anatomic. Fractures of the radial head and radial neck correspond to 1.
Once inserted over the taper, the radial head is secured using the impactor fig. Pdf radial head fracture associated with posterior. Results measurements showed a mean dorsal hook angle of product overview the acumed elbow plating system offers multiple fixation options for fractures of the distal humerus, olecranon, and coronoid, as well as osteotomies of. Arthroscopic radial head excision in managing elbow trauma. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty.
Week 1 begin elbow active rom and activeassisted rom. This study was performed on 12 patients with traumatic elbow fracture. Coronoid reconstruction using the excised radial head in. Radial head arthroplasty modern implants unipolar or bipolar, monoblock or modular, anatomical or nonanatomical, cemented or pressfit correct diameter, height, medial offset and cervicocephalic angle bipolarity permits an automatic positioning of the radial head with respect to the neck and the opposite. Weiss, mdb introduction the radial nerve is the principal nerve in the upper extremity that subserves the extensor compartments of the arm. Second, the modular head is placed over the taper while applying longitudinal distraction andor varus stress to distract the radiocapitellar interface sufficiently to permit the radial head to be inserted. The acumed anatomic radial head slideloc system consists of modular heads and stems with accessories for anatomical replacement of the proximal portion of the radius and restore the natural articulation of the radial head with the radial notch of. May 26, 20 the explor modular radial head replacement from biomet is indicated for degenerative or posttraumatic conditions of the radiohumeral joint. The radial head articulates with the capitellum and radial greater sigmoid notch of the ulna figure a. Some radial head fractures that are deemed unfixable involve only a portion of the articular surface, leaving half or more of the head and neck and thus length of.
Radial head fracture is the most common bony injury to the adult elbow. Align laser marks and impact the head and stem, then lock the morse taper using the head impactor trms05 and a mallet. The mason classification of radial head fractures was described by mason in 1954. The ellipsoid shape of the implant is intended to mimic the natural radial head. Pain, mainly on outside of elbow swelling decreased range of motion of the elbow.
Synthes radial head prosthesis system, surgical instrument motors and accessories product usage. This latest addition to our anatomic radial head solutions offers further refinements to the first and only anatomically shaped radial head prosthesis. Comments about the acumed anatomic radial head system. Radial engineering headload user manual pdf download.
Coronoid reconstruction using the excised radial head has only rarely been described in the orthopaedic literature 35, but our case is unique in that adequate stability of the elbow was achieved intraoperatively to permit immediate range of motion of the elbow. The evolve modular radial head system employs the advantages of. A total of eighty patients of fractures were analyzed with twenty. The acutrak 2 mini and micro instruments are included in the base of the tray, as well as the locking radial head plate system. This system oers a family of precontoured plates designed for use in the. Results of ulnar shortening osteotomy with a new plate. The acumed s ulnar shortening system was utilized in all cases. The anatomic radial head system is a comprehensive solution for radial head fractures. Kocher approach through the interval between the anconeus and extensor carpi ulnaris muscles. For first aid, immobilize the arm and take the child to the doctors office or emergency room. The explor radial head plates are designed to fit within the safe zone of the proximal radius, which is the area of the radial head that does not articulate with. This captures both the signal from the head plus the reactive load from the speaker cabinet for a more natural feel.
Class 2 device recall acumed slideloc anatomic radial head system. Chapter 24 radial head fracture part a general considerations, conservative treatment, and open reduction and internal fixation roger p. Aug 28, 2007 explor modular radial head data collection the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Prosthetic models for replacement of the radial head can be classified as unipolar or bipolar, monoblock or modular, anatomical or nonanatomical, and cemented or pressfit. Case report comminuted radial head fractures treated by. Surgical management of mason type iii radial head fractures.
The explor radial head plating system offers a rim and neck plate featuring either a standard or small curvature figure 5. Anatomical, clinical, and electrodiagnostic features of radial neuropathies leo h. The acutrak 2 mini system can be included in the base of the tray,as well as the mayo clinic radial head plate if needed upon request. The anatomic radial head system from acumed is indicated for radial head replacement after comminuted fracture. Explor modular radial head multiple sizing options for optimal patient fit three head diameters20, 22 and 24mm five head heights10, 12, 14, 16 and 18mm five stem sizes5 x 22, 6 x 24, 7 x 26, 8 x 28 and 9 x 30mm fully interchangeable parts allow for 75 different combinations exclusive slide design for. Inspection of the radial head and trauma to the neck will determine if the standard or long collar radial stem implant will be used. The acumed anatomic radial head prosthesis was designed to treat. Radial head fracture the radial head is the proximal portion of the radius smaller of the two arm bones.
Radial head, radiocapitellar and total elbow arthroplasties. Mason type iii radial head fractures treated by anatomic. Radial head subluxation, common among toddlers, is caused by traction on the forearm and usually manifests as refusal to move the elbow pseudoparalysis. The anatomic radial head system is a comprehensive solu tion for radial head fractures. Radial head plating system a straightforward solution systrm treating fractures when the radial head is salvageable. In patients elbows the initial operation had been undertaken within one week of a fracture of the radial head, at one to six weeks in seven patients seven elbows and more. Operative guides below all pdf files, be patient they do take time to load. The acumed radial head plating system provides a method for the treatment of fractures when the radial head is salvageable.
Prosthesis, elbow, hemi, radial, polymer product code kwi. A prospective randomised controlled trial was employed to investigate 45 patients with unstable, multifragmented fractures of the radial head, from january 2004 to june 2007. If you need help accessing information in different file formats. Materials and methods 40 human elbows mean age, 68 years. Explor modular radial head surgical technique zimmer biomet. The acumed anatomic radial head system includes the first anatomically shaped radial head prosthesis introduced to the orthopaedic industry. Radial head fractures are frequently caused by trauma to the elbow. Acurned anatomic radial head system acumed anatomic radial head long stems acumed arh slidlelocrh system. A radial head replacement is more effective in comminuted radial head fractures. Anatomic radial head solutions surgical technique acumed. A radial head replacement procedure may be performed to treat severely fragmented fractures of the radial head. Anatomical, clinical, and electrodiagnostic features of. The rhs implant has been designed to maintain congruence between the prosthesis, distal humerus and proximal ulna. Many innovative design features are incorporated into the implant heads and stems, as well as the instrumentation to improve the surgical technique.
In the literature, there are few reports of radial. Acumed anatomic radial head solutions surgical technique 10 implant assembly after determining the correct size head and stem with the trials, place the implant stem into the appropriate size hole in the morse taper impactor block. Explor modular radial head data collection full text view. The intraclass correlation coefficient was between 0. Oct 11, 2018 radial dislocation may be caused by a sudden pull on a childs arm or hand. A radial nerve injury associated with a humeral shaft fracture is an important injury pattern among trauma patients. The acumed anatomic radial head system provides a comprehensive solution that includes the first anatomicallyshaped radial head prosthesis on the market and is equipped with the tools needed to restore the patients anatomy in a radial head replacement surgery. Between 1998 and 2008, 44 consecutive patients 47 elbows underwent removal of a failed metallic radial head replacement. Every screw in the radial head should pass through a plate. Previously radial head excision was a popular treatment, now it is being replaced by open reduction and internal fixation or radial head replacement. The radial head makes a 15 lateral angle to the radial shaft away from the tuberosity figure b.
Odriscoll, md, phd, the acumed anatomic radial head solutions 2 system includes 924 head and stem combinations and systemspecific instrumentation to help streamline the surgeons. Explor modular radial head trial reduction continued slide the slot located on the undersurface of the radial head along the ridge located on the proximal radial stem until the head is fully seated figure 10. The system is modular comprising a stem, collar and cobalt chrome head. This study is to find out the incidence of radial nerve palsy and to analyze results of treatment of fracture shaft of humerus associated with radial nerve injury to improve outcome and avoid longterm morbidity. This is an offlabel use of radial head arthroplasty, however one of the senior authors will perform radial head arthroplasty in adolescents with closed physes in select cases of overgrown. Replacement of the radial head for degenerative or posttraumatic disabilities presenting pain, crepitation, and decreased motion at the radiohumeral andor proximal radioulnar joint with. Case report comminuted radial head fractures treated by the. We prefer to use a slightly smaller diameter, based on the fracture fragments, to implant a radial head prosthesis that is more like the bony part of the native radial head, excluding the cartilage component. If the radial head had plastic deformity or malunion that blocked forearm rotation, it was excised or replaced tornier or acumed, hillsboro, or, usa. Degenerative or posttraumatic disabilities presenting pain, crepitation, and decreased motion at the radiohumeral andor proximal radioulnar joint with.
Class 2 device recall synthes radial head prosthesis system. The acumed anatomic radial head slideloc system consists of modular heads and stems with accessories for anatomical replacement of the proximal portion of the radius and restore the natural articulation of the radial head with the radial notch of the ulna and capitellum of the distal humerus. Class 2 device recall acumed slideloc anatomic radial head. Noncircular shape of acumed s anatomic radial head 18. This evolution is due to an increased understanding of the role of the radial head in elbow and forearm stability 7. This fixation is maximized when the screws in the articular plxting interdigitate with the screws from the acumed lateral column plate on the lateral side.
The acumed anatomic radial head prosthesis is designed to provide a precise anatomical implant to replace the patients native radial head. The goal of treatment of fractures of the radial head is the preservation of elbow flexion and extension as well as pronation and supination of the forearm. Liverpool radial head replacementbiomet, swanson titanium radial head wright medical technology is becoming obsolete because the absence of modularity does not enable the anatomy and. As in radial head resection alone for a comminuted fracture, radial head resection and replacement arthroplasty should be done soon after the fracture occurs, preferably within a few days. Pdf radial head prostheses rhp have been developed to decrease the complications rate following a radial head resection surgery. This study describes a case series of 15 patients with radial head fractures who underwent radial head excision using an arthroscopic technique. The aim of this paper was to present the mediumterm results of the acumed anatomic radial head system aarhs. Intended for primary and revision joint replacement of the radial head. With the anatomic radial head system, the surgeon is equipped with the tools needed to properly restore the. Page 5 true to the music phazer section for engineers that prefer to combine a direct feed with a microphone, the headload has also been equipped with a radial phazer. The implant is fixed in place using a unique rotational locking mechanism with. Place as many screws as possible in the radial head. Radial head fractures account for approximately onethird of all adult elbow fractures. Radial head implants with 4 stems and 6 head sizes.
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