Skip to main content

Abstract

Radial head arthroplasty (RHA) is a valuable addition to the surgeon’s armamentarium for treatment of complex, comminuted radial head fractures with associated elbow instability. The major goal of radial head arthroplasty is to replicate the length of the native radial head and to avoid “overstuffing” or “understuffing” the radiocapitellar joint. It is important to assess for ligamentous injuries as well and repair these as necessary to restore elbow stability and allow joint range of motion. The goal of all rehabilitation protocols for the elbow is early, safe mobilization. We present our technique as well as tips and tricks for successful radial head implant arthroplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Van Riet RP, Glabbek F, Morrey BF. Radial head fracture. In: The elbow and its disorders. 4th ed. Philadelphia: Saunders Elsevier; 2009. p. 359–89.

    Google Scholar 

  2. Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM. The epidemiology of radial head and neck fractures. J Hand Surg Am. 2012;37(1):112–9.

    Article  Google Scholar 

  3. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32.

    Article  CAS  Google Scholar 

  4. Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987;216:109–19.

    Article  Google Scholar 

  5. Sheps DM, Kiefer KRL, Boorman RS, Donaghy J, Lalani A, Walker R, et al. The interobserver reliability of classification systems for radial head fractures: the Hotchkiss modification of the Mason classification and the AO classification systems. Can J Surg. 2009;52(4):277–82.

    PubMed  PubMed Central  Google Scholar 

  6. van Riet RP, Morrey BF. Documentation of associated injuries occurring with radial head fracture. Clin Orthop Relat Res. 2008;466(1):130–4.

    Article  Google Scholar 

  7. van Riet RP, Morrey BF, O’Driscoll SW, Van Glabbeek F. Associated injuries complicating radial head fractures: a demographic study. Clin Orthop Relat Res. 2005;441:351–5.

    Article  Google Scholar 

  8. Davidson PA, Moseley JB, Tullos HS. Radial head fracture. A potentially complex injury. Clin Orthop Relat Res. 1993;297:224–30.

    Google Scholar 

  9. Duckworth AD, Watson BS, Will EM, Petrisor BA, Walmsley PJ, Court-Brown CM, et al. Radial head and neck fractures: functional results and predictors of outcome. J Trauma. 2011;71(3):643–8.

    PubMed  Google Scholar 

  10. Duckworth AD, Wickramasinghe NR, Clement ND, Court-Brown CM, McQueen MM. Long-term outcomes of isolated stable radial head fractures. J Bone Joint Surg Am. 2014;96(20):1716–23.

    Article  Google Scholar 

  11. Herbertsson P, Josefsson PO, Hasserius R, Karlsson C, Besjakov J, Karlsson MK. Displaced Mason type I fractures of the radial head and neck in adults: a fifteen- to thirty-three-year follow-up study. J Shoulder Elb Surg. 2005;14(1):73–7.

    Article  Google Scholar 

  12. Antuña SA, Sánchez-Márquez JM, Barco R. Long-term results of radial head resection following isolated radial head fractures in patients younger than forty years old. J Bone Joint Surg Am. 2010;92(3):558–66.

    Article  Google Scholar 

  13. Furry KL, Clinkscales CM. Comminuted fractures of the radial head. Arthroplasty versus internal fixation. Clin Orthop Relat Res. 1998;353:40–52.

    Article  Google Scholar 

  14. King GJ, Zarzour ZD, Rath DA, Dunning CE, Patterson SD, Johnson JA. Metallic radial head arthroplasty improves valgus stability of the elbow. Clin Orthop Relat Res. 1999;368:114–25.

    Article  Google Scholar 

  15. Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJW. Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg. 2005;14(1 Suppl S):195S–201S.

    Article  Google Scholar 

  16. Mikíc ZD, Vukadinovíc SM. Late results in fractures of the radial head treated by excision. Clin Orthop Relat Res. 1983;181:220–8.

    Article  Google Scholar 

  17. Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am. 2005;87(1):76–84.

    Article  Google Scholar 

  18. Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84(10):1811–5.

    Article  Google Scholar 

  19. Halls AA, Travill A. Transmission of pressures across the elbow joint. Anat Rec. 1964;150:243–7.

    Article  CAS  Google Scholar 

  20. Markolf KL, Lamey D, Yang S, Meals R, Hotchkiss R. Radioulnar load-sharing in the forearm. A study in cadavera. J Bone Joint Surg Am. 1998;80(6):879–88.

    Article  CAS  Google Scholar 

  21. Shore BJ, Mozzon JB, MacDermid JC, Faber KJ, King GJW. Chronic posttraumatic elbow disorders treated with metallic radial head arthroplasty. J Bone Joint Surg Am. 2008;90(2):271–80.

    Article  Google Scholar 

  22. Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJW. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006;88(10):2192–200.

    PubMed  Google Scholar 

  23. Doornberg JN, Parisien R, van Duijn PJ, Ring D. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am. 2007;89(5):1075–80.

    Article  Google Scholar 

  24. Chanlalit C, Shukla DR, Fitzsimmons JS, An K-N, O’Driscoll SW. Effect of hoop stress fracture on micromotion of textured ingrowth stems for radial head replacement. J Shoulder Elb Surg. 2012;21(7):949–54.

    Article  Google Scholar 

  25. Flinkkilä T, Kaisto T, Sirniö K, Hyvönen P, Leppilahti J. Short- to mid-term results of metallic press-fit radial head arthroplasty in unstable injuries of the elbow. J Bone Joint Surg Br. 2012;94(6):805–10.

    Article  Google Scholar 

  26. Sershon RA, Luchetti TJ, Cohen MS, Wysocki RW. Radial head replacement with a bipolar system: an average 10-year follow-up. J Shoulder Elb Surg. 2018;27(2):e38–44.

    Article  Google Scholar 

  27. Burkhart KJ, Mattyasovszky SG, Runkel M, Schwarz C, Küchle R, Hessmann MH, et al. Mid- to long-term results after bipolar radial head arthroplasty. J Shoulder Elb Surg. 2010;19(7):965–72.

    Article  Google Scholar 

  28. Guss MS, Hess LK, Baratz ME. The naked capitellum: a surgeon’s guide to intraoperative identification of posterolateral rotatory instability. J Shoulder Elb Surg. 2019;28(5):e150–5.

    Article  Google Scholar 

  29. Smith AM, Urbanosky LR, Castle JA, Rushing JT, Ruch DS. Radius pull test: predictor of longitudinal forearm instability. J Bone Joint Surg Am. 2002;84(11):1970–6.

    Article  Google Scholar 

  30. Rowland AS, Athwal GS, MacDermid JC, King GJW. Lateral ulnohumeral joint space widening is not diagnostic of radial head arthroplasty overstuffing. J Hand Surg Am. 2007;32(5):637–41.

    Article  Google Scholar 

  31. Shors HC, Gannon C, Miller MC, Schmidt CC, Baratz ME. Plain radiographs are inadequate to identify overlengthening with a radial head prosthesis. J Hand Surg Am. 2008;33(3):335–9.

    Article  Google Scholar 

  32. Galik K, Baratz ME, Butler AL, Dougherty J, Cohen MS, Miller MC. The effect of the annular ligament on kinematics of the radial head. J Hand Surg Am. 2007;32(8):1218–24.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Tu, LA., Nakashian, M.N., Baratz, M.E. (2022). Radial Head Arthroplasty. In: Geissler, W.B. (eds) Wrist and Elbow Arthroscopy with Selected Open Procedures. Springer, Cham. https://doi.org/10.1007/978-3-030-78881-0_61

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-78881-0_61

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78880-3

  • Online ISBN: 978-3-030-78881-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics