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Radial Head Replacement for Radial Head Fractures

Objective: This study aimed to analyze the clinical results after treatment of complex elbow injuries with modular anatomic radial head prosthesis (MARHP), along with ligament repair and fracture fixation. Design: Retrospective. Setting: District teaching hospital. Patients/Participants: The inclusion criteria were all patients with traumatic elbow instability after acute fracture or fracture dislocation, where the radial head was comminuted and irreparable at the time of surgery (Mason type III) and there was associated valgus laxity of the elbow. Of 14 patients, 12 with radial head prosthesis were available for the study. Intervention: MARHP (Acumed, Hillsboro, OR) was used to replace irreparable and comminuted radial head fractures when it was associated with valgus instability. Main Outcome Measurements: All patients were evaluated clinically and radiographically for a mean follow-up of 42 months (range, 22–58 months). Results: Patients recovered a similar range of motion between affected and unaffected elbows. Stability was restored to all 12 elbows, and all patients had a good or excellent result according to Mayo Elbow Performance Index and a disability of the arm, shoulder, and hand survey. Radiographic measurement revealed a congruent elbow joint. Conclusion: The MARHP is effectively restoring stability and congruency to the elbow joint. There was no evidence of arthritic radiocapitellar joint, capitellar osteopenia, significant proximal radial migration of the implant, or any major complications. Outcomes were optimized by recognition and addressing the associated injuries. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.