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Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization by G.I. Bain, N. Ashwood, R. Baird,

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Presentation on theme: "Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization by G.I. Bain, N. Ashwood, R. Baird,"— Presentation transcript:

1 Management of Mason Type-III Radial Head Fractures with a Titanium Prosthesis, Ligament Repair, and Early Mobilization by G.I. Bain, N. Ashwood, R. Baird, and R. Unni J Bone Joint Surg Am Volume 87(1 suppl 1):136-147 March 1, 2005 ©2005 by The Journal of Bone and Joint Surgery, Inc.

2 Anteroposterior and lateral radiographs showing a radial head fracture with an associated fracture of the coronoid process and an unstable elbow joint. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

3 Algorithm for the management of acute traumatic elbow instability. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

4 Fig. 3-A The global extensile approach to the elbow allows exposure of both collateral ligaments. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

5 Clinical photograph of the global extensile approach to the elbow. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

6 Fig. 4-A Following exposure of the lateral ulnar collateral ligament (LUCL), the capsule anterior to the ligament is incised with use of a z-shaped incision. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

7 Photograph showing a z-shaped incision. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

8 The anterior capsular flap, when released from the epicondyle, exposes the lateral side of the joint without violating the lateral ulnar collateral ligament (LUCL). G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

9 Releasing the posterior capsular flap allows insertion of the metallic prosthesis but disrupts the lateral ulnar collateral ligament and therefore makes the elbow unstable. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

10 Valgus stress test with the radial head excised. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

11 A Kocher clamp is placed on the radial neck, and the radius is axially loaded to assess the competence of the interosseous membrane. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

12 Postoperative lateral radiograph of an elbow with the EVOLVE radial head prosthesis (Wright Medical Technology). G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

13 Fig. 6-A Exposure of the medial portion of the joint. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

14 Photograph showing exposure of the medial portion of the joint. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

15 Stability of the elbow. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

16 The lateral collateral ligament complex is stabilized with transosseous interrupted sutures, with the elbow held in 30° of flexion and the forearm in full pronation. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.

17 The dynamic elbow suspension splint elevates the extended elbow. G.I. Bain et al. J Bone Joint Surg Am 2005;87:136-147 ©2005 by The Journal of Bone and Joint Surgery, Inc.


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