Universität zu Köln

Cucchi, Davide ORCID: 0000-0001-6284-7977, Luceri, Francesco, Celli, Andrea, Menon, Alessandra, Barco, Raul, Wegmann, Kilian, Randelli, Pietro, Eygendaal, Denise and Arrigoni, Paolo ORCID: 0000-0002-8273-9823 (2020). Fracture Pattern Influences Radial Head Replacement Size Determination Among Experienced Elbow Surgeons. Indian J. Orthop., 54 (5). S. 539 - 548. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1998-3727

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Abstract

BackgroundCorrect sizing is challenging in radial head replacement and no consensus exists on the implant's optimal height and width to avoid elbow stiffness and instability. Studies exists, suggesting how to appropriately choose the implant size, but the manner by which the fracture pattern influences the surgeons' operative choices was not investigated.MethodsThe radial heads of four fresh-frozen cadaveric specimens were excised, measured, and fractured to simulate four patterns: three fragments (A); four fragments (B); comminuted (C); comminuted with bone loss (D). Nine examiners were asked to indicate first the maximum diameter of the radial heads with the help of dedicated sizing dishes and then the appropriate implant size with trial implants. Accuracy and precision were determined. A coefficient of variation was calculated and agreement was evaluated with the Bland-Altman method.ResultsAccuracy and precision of radial head diameter estimation with dedicated sizing dish were 96.73% and 93.64%, (best pattern, D; worst, C). Accuracy and precision of radial head diameter estimation with trial implants were 99.71% and 90.66% (best pattern, A; worst, D). Frequent modifications occurred between the initial radial head size proposal based on the sizing dish and the radial head size chosen after use of the trial implants (47.2%).ConclusionsDiameter estimation of radial heads with dedicated sizing dishes may be underestimated in comminuted fractures; when bone loss is present, this may lead to an overestimation, especially when using trial implants. Care is essential to determine the optimal size of the implant and to avoid overlenghtening and oversizing, which can be responsible for implant failure.Level of EvidenceBasic Science Study.Clinical RelevanceKnowledge of the manner by which the fracture pattern influences radial head replacement size estimation can help preventing overlenghtening and oversizing during this procedure.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cucchi, Davide UNSPECIFIED orcid.org/0000-0001-6284-7977 UNSPECIFIED Luceri, Francesco UNSPECIFIED UNSPECIFIED UNSPECIFIED Celli, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Menon, Alessandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Barco, Raul UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Randelli, Pietro UNSPECIFIED UNSPECIFIED UNSPECIFIED Eygendaal, Denise UNSPECIFIED UNSPECIFIED UNSPECIFIED Arrigoni, Paolo UNSPECIFIED orcid.org/0000-0002-8273-9823 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-321837
DOI:	10.1007/s43465-020-00039-0
Journal or Publication Title:	Indian J. Orthop.
Volume:	54
Number:	5
Page Range:	S. 539 - 548
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1998-3727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROSTHESIS; DIAMETER; IMPLANT Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32183