Proximal Radial Drift Following Radial Head Resection

Author(s): Schiffern A, Bettwieser S, Porucznik C, Crim J, Tashijan R

Source: J Shoudler and Elbow Surg 20 426-33, 2011.

Summary:
This is a retrospective review of 13 patients who had undergone a radial head resection for a variety of injury patterns to determine the average degree of shortening of the radius following resection.  The authors concluded that the proximal radial stump was determined to have migrated medially and posteriorly when compared to the contralateral side.  They found that increase resection greater than 2cm resulted in larger amounts of migration.  They were able to conclude that only the initial dislocation injury pattern was associated with the ultimate function outcome. 
 
The clinical significance of this paper is that the proximal radius does in fact migrate both posteriorly and shifts in the medial to lateral plane following radial head resection.  This is a three dimensional problem as the radius does not just migrate proximally along its axis. This does in fact have implications for the development of both ulnar positive variance at the wrist as well as the progression of radial capitellar and proximal radioulnar joint changes in the long term.