Radial Head Replacement of the Elbow

The elbow joint is formed by the junction of the humerus (upper arm bone), and radius and ulna (forearm bones). The radius is the shorter of the two forearm bones and can be divided into the head, neck and body. Radial head fractures are common injuries that occur when you stretch out your arm to try to break a fall. While conservative methods of immobilization or surgical fixation with screws can effectively treat minor fractures, multiple fractures and dislocation of the elbow joint usually requires the removal of the radial head and replacement with a prosthesis. It is indicated when conservative methods fail, fixation with screws is not possible and when removal of the radial head causes instability.

To perform radial head replacement, your doctor makes an incision at the side of the elbow. All the fragments of broken bone are carefully removed without injuring the surrounding tissues. Your surgeon determines the correct size of the prosthesis to facilitate a perfect fit. The radial neck is trimmed to receive the prosthesis. The central cavity of the radial body just below the radial neck is removed with an awl. Your surgeon then inserts the chosen prosthesis and checks for stability and tracking during various movements of the arm. The prosthesis is then cemented into position and the incision sutured.

Following radial head replacement, your arm is placed in a splint. After about 6 to 8 weeks, you will be taught stretching and strengthening exercises to improve your arm’s range-of-motion and prevent stiffness.

As with all surgeries, radial head replacement may be associated with certain complications such as pain, damage to adjacent nerves, muscle inflammation, forearm deformity, elbow dislocation, prosthetic failure and abnormal bone formation (calcification).