DePuy Synthes Trauma is launching a new radial head prosthesis system just in time for Northerners who break their smaller bone (radius) in the forearm while cushioning their fall on the ice. The most common cause of a radial head fracture is breaking a fall with an outstretched arm.
DePuy Synthes Trauma’s New Radial Head System
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Secondary
The radius bone goes from your elbow to your wrist. The radial head is the top of the radial bone, just below your elbow.
The company announced the launch of the Radial Head Prosthesis system for primary and revision joint replacement of the radial head to restore joint function on December 13, 2013. The company said the new system offers several benefits over current technologies.
Harry Hoyen, M.D., Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland, Ohio, and company consultant, said, “This system is a comprehensive solution for the radial head replacement that permits the surgeon to choose whether a long or short stem is best for the proximal radius. With the system, a novel surface etching permits on-growth and stability; the head element can be placed onto either stem and is designed to take into account the PRUJ and radiocapitellar articulation for each respective size. There also is a side-loading option for intraoperative assembly.”
According to the company, the modularity of the system – 24 heads and 10 stems allowing for 240 possible implant combinations – enables surgeons to restore the appropriate height, which may aid in elbow stability. The side-loading capability facilitates in-situ insertion and assembly, which may allow for a smaller incision than a top-loading device, while the stem texture ensures a uniform press fit in the radial canal. The system also provides an integrated connection screw to facilitate assembly, along with simple instrumentation.
The American Academy of Orthopaedic Surgeons states that radial head fractures are common injuries, occurring in about 20% of all acute elbow injuries. They are more frequent in women than in men and occur most often between 30 and 40 years of age.
Approximately 10% of all elbow dislocations involve a fracture of the radial head. As the upper arm bone (humerus) and the ulna return to their normal alignment, a piece of the radial head bone could be chipped off (fractured).
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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