Scientific Articles   |    
Analysis of Radial Head Implant Length with Use of Contralateral Elbow Radiographs
George S. Athwal, MD, FRCSC1; Dominique M. Rouleau, MD, MSc, FRCSC2; Joy C. MacDermid, BScPT, MSc, PhD1; Graham J.W. King, MD, MSc, FRCSC1
1 Hand and Upper Limb Centre, St. Joseph's Health Care, University of Western Ontario, 268 Grosvenor Street, London, ON N6A 4L6, Canada. E-mail address for G.S. Athwal: gathwal@uwo.ca
2 University of Montreal, Hôpital Sacré-Coeur, 5400 Boulevard Gouin Ouest, Montreal, QC H4J 1C5, Canada
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Based on an original article: J Bone Joint Surg Am. 2011;93:1339-46.

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2012 Mar 28;02(01):e6 1-6. doi: 10.2106/JBJS.ST.K.00029
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



This article describes a technique in which measurements are obtained from radiographs of the contralateral, normal elbow to predict the magnitude of overlengthening resulting from use of a metallic radial head prosthesis.

Step 1: Obtain Bilateral Elbow Radiographs

Obtain bilateral digital anteroposterior radiographs of the elbows that are orthogonal to the forearm in 45° of flexion and neutral forearm rotation.

Step 2: Perform Radiographic Measurements of the Contralateral, Normal Elbow

Draw the angle on the radiograph of the normal elbow.

Step 3: Perform Radiographic Measurements of the Radial Head Implant

Draw the same lines and angle and perform the same measurements on the implant radiograph.

Step 4: Calculate Radial Head Implant Length

The virtual length of the native radial head implant (L-NRH) is subtracted from the virtual length of the radial head implant (L-RHI), which results in the magnitude of the radial head implant overlengthening in millimeters: (L-RHI) – (L-NRH) = overlengthening.


The radiographic measurement technique was validated in a cadaveric study.

What to Watch For



Pitfalls & Challenges

Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Essential Surgical Techniques?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    Provided by:
    Essential Surgical Techniques
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Virginia - OrthoVirginia
    Massachusetts - Boston Medical Center and Boston University School of Medicine
    NY - Icahn School of Medicine at Mount Sinai