The Effect upon the Inferior Radio-ulnar Joint of Excision of the Head of the Radius in Adults.

MATERIAL Fifty-eight adults were reviewed in whom the radial head had been excised, either for comminuted or severely depressed marginal fractures (forty-six cases), or after fracturedislocations of the elbow (twelve cases). The average follow-up was seven and a half years. There were thirty-two men and twenty-six women, and, as in other reported series, the highest incidence was between thirty and fifty years of age. Because the population of the Oxford area is a moving one, follow-up was impossible in many instances, and of all the cases suitable for study only 58 per cent were available. Consequently this is a heterogeneous series and it is not permissible to draw any statistical conclusions. This review deals only with patients who were operated upon for radial head fracture within four weeks ofinjury and patients with fractures of the shafts of the forearm bones have not been included. Our records do not reveal a case in which fracture-dislocation of the head ofthe radius was combined with inferior radio-ulnar dislocation as described by Curr and Coe (1946) and Essex-Lopresti (1950). Antero-posterior and lateral radiographs at the extremes of rotation were taken of the affected elbow in fullest extension and in right-angled fiexion. Comparative radiographs of the normal and the affected wrists were taken in maximum pronation with the arm adducted to the trunk and the elbow at right-angled flexion in order to prevent deceptive rotation at the shoulder. TABLE I