Technique Spotlight: Radial Head Arthroplasty

Indications

Radial head arthroplasty (RHA) is a valuable surgical option for complex, comminuted radial head fractures with associated elbow instability. An RHA is recommended when anatomic repair and fixation of a radial head fracture is not possible and removal of the radial head alone may not be advantageous due to instability. Injury to the lateral ulnar collateral ligament (LUCL) complex and the medial collateral ligament (MCL) will lead to greater elbow instability if the radial head is simply excised and the ligaments are not repaired. Similarly, injury to the interosseous membrane will lead to longitudinal forearm instability if the radial head is not restored. The majority of these associated ligamentous injuries occur with Mason type III radial head fractures. Furthermore, the elbow that requires a soft tissue repair is also one that benefits from early range of motion so as to prevent stiffness. A radial head replacement can, at times, allow for a more rapid advancement in range of motion than an open reduction internal fixation (ORIF).