{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:03:25Z","timestamp":1790402605441,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,4,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radial head arthroplasty is commonly used to treat acute unreconstructible radial head fractures. The purpose of this study was to report on the clinical and radiographic outcomes at a minimum follow-up of five years after radial head arthroplasty with a modular metallic implant for the treatment of acute radial head fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The cases of fifty-five patients with unreconstructible radial head fractures treated acutely with a smooth-stemmed modular metallic radial head implant were retrospectively reviewed. A wide variety of injuries, which ranged from isolated radial head fractures to so-called terrible triad injuries, were included. All patients returned for an interview, physical examination, and radiographic evaluation at a mean of eight years (range, five to fourteen years) postoperatively. Elbow and forearm motion, elbow strength, and grip strength were measured. Radiographs were evaluated, and validated patient-rated outcome questionnaires were completed. A longitudinal subgroup analysis was performed for thirty-three patients who were previously evaluated at two years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At a mean of 8.2 \u00b1 2.9 years, the mean arc of flexion (and standard deviation) of the affected elbow was 11\u00b0 \u00b1 14\u00b0 to 137\u00b0 \u00b1 15\u00b0. Elbow strength and motion were significantly diminished compared with the unaffected elbow (p &lt; 0.05). The mean Mayo Elbow Performance Index (MEPI) was 91 \u00b1 13 points. Twenty-five patients (45%) had stem lucencies; twenty-one (38%), ulnohumeral arthritis; and twenty (36%), heterotopic ossification, including one with radioulnar synostosis. Two patients underwent secondary elbow surgery, but no patient required implant removal or revision. In the subgroup evaluated longitudinally, there was a significant improvement in MEPI scores from the two-year to the eight-year follow-up (p = 0.012), with no loss of motion or strength (p &gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The mid-term outcomes of radial head arthroplasty with a smooth-stemmed modular metallic prosthesis are comparable with previously reported short-term outcomes, with no evidence of functional deterioration. Radial head arthroplasty with a smooth-stemmed metallic modular implant is a good treatment option for patients with acute unreconstructible radial head fractures, and sustained clinical outcomes may be expected beyond five years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00128","type":"journal-article","created":{"date-parts":[[2016,4,6]],"date-time":"2016-04-06T15:47:55Z","timestamp":1459957675000},"page":"527-535","source":"Crossref","is-referenced-by-count":91,"title":["Radial Head Fractures Treated with Modular Metallic Radial Head Replacement"],"prefix":"10.2106","volume":"98","author":[{"given":"Jonathan P.","family":"Marsh","sequence":"first","affiliation":[{"name":"Pan Am Clinic, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby","family":"Grewal","sequence":"additional","affiliation":[{"name":"Roth | McFarlane Hand & Upper Limb Centre, St. Joseph\u2019s Health Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Faber","sequence":"additional","affiliation":[{"name":"Roth | McFarlane Hand & Upper Limb Centre, St. Joseph\u2019s Health Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren S.","family":"Drosdowech","sequence":"additional","affiliation":[{"name":"Roth | McFarlane Hand & Upper Limb Centre, St. Joseph\u2019s Health Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Athwal","sequence":"additional","affiliation":[{"name":"Roth | McFarlane Hand & Upper Limb Centre, St. Joseph\u2019s Health Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham J.W.","family":"King","sequence":"additional","affiliation":[{"name":"Roth | McFarlane Hand & Upper Limb Centre, St. Joseph\u2019s Health Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"12","key":"bib1-20230714","first-page":"1136","article-title":"Radial head fractures","volume":"95","author":"Lapner","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/00005373-200101000-00009","article-title":"The functional outcome with metallic radial head implants in the treatment of unstable elbow fractures: a long-term review","volume":"50","author":"Harrington","year":"2001","journal-title":"J Trauma."},{"issue":"10","key":"bib3-20230714","first-page":"2192","article-title":"Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes","volume":"88","author":"Grewal","year":"2006","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.2106\/00004623-200108000-00010","article-title":"Arthroplasty with a metal radial head for unreconstructible fractures of the radial head","volume":"83","author":"Moro","year":"2001","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"274","DOI":"10.2106\/00004623-200402000-00009","article-title":"Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization","volume":"86","author":"Ashwood","year":"2004","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2106\/JBJS.F.01535","article-title":"Chronic posttraumatic elbow disorders treated with metallic radial head arthroplasty","volume":"90","author":"Shore","year":"2008","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1302\/0301-620X.94B6.28176","article-title":"Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow","volume":"94","author":"Flinkkil\u00e4","year":"2012","journal-title":"J Bone Joint Surg Br."},{"issue":"11","key":"bib8-20230714","first-page":"2469","article-title":"Midterm results with a bipolar radial head prosthesis: radiographic evidence of loosening at the bone-cement interface","volume":"89","author":"Popovic","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib9-20230714","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00130911-200112000-00003","article-title":"Metallic radial head arthroplasty","volume":"5","author":"King","year":"2001","journal-title":"Tech Hand Up Extrem Surg."},{"issue":"7","key":"bib10-20230714","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.2106\/JBJS.H.01161","article-title":"Determination of correct implant size in radial head arthroplasty to avoid overlengthening","volume":"91","author":"Frank","year":"2009","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib11-20230714","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/j.jse.2013.04.005","article-title":"Selecting the diameter of a radial head implant: an assessment of local landmarks","volume":"22","author":"Alolabi","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"Suppl 1 Pt 2","key":"bib12-20230714","doi-asserted-by":"crossref","first-page":"250","DOI":"10.2106\/JBJS.J.00356","article-title":"Determination of correct implant size in radial head arthroplasty to avoid overlengthening: surgical technique","volume":"92","author":"Athwal","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"bib13-20230714","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1016\/j.jse.2013.06.014","article-title":"Measurements of the ispilateral capitellum can reliably predict the diameter of the radial head","volume":"22","author":"Leclerc","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"5","key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jhsa.2007.02.024","article-title":"Lateral ulnohumeral joint space widening is not diagnostic of radial head arthroplasty overstuffing","volume":"32","author":"Rowland","year":"2007","journal-title":"J Hand Surg Am."},{"issue":"6","key":"bib15-20230714","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/BOT.0000000000000009","article-title":"The effect of radial head implant length on radiocapitellar articular properties and load transfer within the forearm","volume":"28","author":"Lanting","year":"2014","journal-title":"J Orthop Trauma."},{"issue":"2","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0894-1130(01)80040-5","article-title":"Outcome evaluation in patients with elbow pathology: issues in instrument development and evaluation","volume":"14","author":"MacDermid","year":"2001","journal-title":"J Hand Ther."},{"issue":"4","key":"bib17-20230714","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S1836-9553(12)70134-0","article-title":"The Patient-Rated Elbow Evaluation (PREE)","volume":"58","author":"Vincent","year":"2012","journal-title":"J Physiother."},{"issue":"3","key":"bib18-20230714","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med Care."},{"issue":"5","key":"bib19-20230714","first-page":"1038","article-title":"Development of the QuickDASH: comparison of three item-reduction approaches","volume":"87","author":"Beaton","year":"2005","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib21-20230714","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.2106\/00004623-197355080-00006","article-title":"Ectopic ossification following total hip replacement. Incidence and a method of classification","volume":"55","author":"Brooker","year":"1973","journal-title":"J Bone Joint Surg Am."},{"key":"bib22-20230714","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/00003086-198703000-00017","article-title":"Results of treatment of fracture-dislocations of the elbow","volume":"216","author":"Broberg","year":"1987","journal-title":"Clin Orthop Relat Res."},{"key":"bib23-20230714","first-page":"17","article-title":"\u201cModes of failure\u201d of cemented stem-type femoral components: a radiographic analysis of loosening","volume":"141","author":"Gruen","year":"1979","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib24-20230714","doi-asserted-by":"crossref","first-page":"453","DOI":"10.2106\/00004623-197658040-00004","article-title":"Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses","volume":"58","author":"Gustilo","year":"1976","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib25-20230714","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2106\/00004623-198163060-00002","article-title":"A biomechanical study of normal functional elbow motion","volume":"63","author":"Morrey","year":"1981","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib26-20230714","doi-asserted-by":"crossref","first-page":"471","DOI":"10.2106\/JBJS.I.01633","article-title":"Functional elbow range of motion for contemporary tasks","volume":"93","author":"Sardelli","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"9","key":"bib28-20230714","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.2106\/00004623-198971090-00011","article-title":"Fractures of the coronoid process of the ulna","volume":"71","author":"Regan","year":"1989","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201604060-00001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:37:10Z","timestamp":1787751430000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201604060-00001"}},"subtitle":["Outcomes at a Mean Follow-up of Eight Years"],"short-title":[],"issued":{"date-parts":[[2016,4,6]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.15.00128","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,6]]}}}