Artikel
Radial Head Resection and Hemi-interposition Arthroplasty in Masada type II deformity in patients with Multiple Osteochondromas; Evaluation of a new surgical technique
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Autoren
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Mark Flipsen
- OLVG, Amsterdam, Netherlands
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S.J. Ham
- OLVG, Amsterdam, Netherlands
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Konrad Mader
- Asklepios Klinik Altona, Hamburg, Germany
| Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: Forearm osteochondromas and deformities are found in patients with Multiple Osteochondromas (MO) with Masada type II deformity. In these patients, the radial head is chronically dislocated from the elbow joint resulting in pain, decreased ROM, instability and cosmetic deformity. The purpose of this study was to evaluate the results of a new surgical technique for Masada type II deformity in MO patients.
Methods: We conducted a prospective cohort study with 14 MO patients: 6 girls and 8 boys; mean age was 13 years (range 8-25 years). 12 patients underwent the new surgical technique after previous distal forearms procedures, 1 patient had a previous proximal correction osteotomy. The surgical technique comprised: radial head resection, hemi-interposition arthroplasty from the extended capsule and the inner layer of the common extensor tendon origin, LUCL augmentation or LUCL graft if indicated, combined with hinged elbow external fixator for 6 weeks or plaster cast. Minimal follow-up was 12 months (range 12-46 months) for evaluation of pain, ROM, stability, patient satisfaction and radiologic appearance of the elbow and wrist. Additionally, patient related outcomes measures concerning functional outcome and quality of life were obtained by the use of questionnaires.
Results and Conclusion: No procedure-related complications were observed; especially no external fixator-related radial nerve injures or Essex Lopresti phenomenon. Correction osteotomy gave a poor result and recurrent dislocation with aggravation of the deformity occurred. We could document major improvements in pain, ROM, stability and patient satisfaction.
In MO patients with a Masada type II deformity of the forearm, radial head resection, interposition arthroplasty, radiohumeral ligament augmentation and temporary stabilisation with a hinged external fixator led to improvements in pain, ROM, stability and patient satisfaction. It is a distinct option for chronic radial head dislocation in patients after levelling procedure of the forearm.
