Treatment of Radial Head Fractures with a Modular Metallic Radial Head Replacement

JBJS Essential Surgical Techniques
Robert LongstaffeJonathan P Marsh

Abstract

Radial head arthroplasty with a smooth-stemmed metallic modular implant is a reliable treatment option for patients with acute unreconstructible radial head fractures, and good clinical outcomes may be expected beyond 5 years of follow-up (Video 1). Obtain a careful history and perform a physical examination along with appropriate imaging to facilitate appropriate treatment decisions. Perform proper operating room setup and patient positioning, as they are required to gain access to all affected structures around the elbow in a safe and efficient manner. Make a midline posterior skin incision with development of a full-thickness lateral fasciocutaneous flap or use a direct lateral incision; the deep interval is determined on the basis of the integrity of the LCL. Remove and preserve all fragments of the radial head for implant sizing. Implant a prosthesis that closely replicates the dimensions of the native radial head, which is the primary goal of the procedure. Sequentially broach the canal until good cortical contact is achieved and undersize the definitive stem by 1 mm to allow implant movement within the canal and appropriate articulation with the capitellum. With the selected trial in place, assess the radial head diamete...Continue Reading

References

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Citations

Jan 2, 2018·The Open Orthopaedics Journal·Robert W Jordan, Alistair Dr Jones
Jul 26, 2021·The Journal of Hand Surgery·Laura A SimsKenneth J Faber

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