Introduction Radial head arthroplasty with a smooth-stemmed metallic modular implant is a reliable treatment option for patients with acute unreconstructible radial head fractures, and good clinical outcomes may be expected beyond 5 years of follow-up (Video 1).
Indications & Contraindications
Step 1: Preoperative Planning Obtain a careful history and perform a physical examination along with appropriate imaging to facilitate appropriate treatment decisions.
Step 2: Operating Room Setup and Patient Positioning Perform proper operating room setup and patient positioning, as they are required to gain access to all affected structures around the elbow in a safe and efficient manner.
Step 3: Approach Make a midline posterior skin incision with development of a full-thickness lateral fasciocutaneous flap or use a direct lateral incision; the deep interval is determined on the basis of the integrity of the LCL.
Step 4: Radial Head Excision Remove and preserve all fragments of the radial head for implant sizing.
Step 5: Implant Sizing Implant a prosthesis that closely replicates the dimensions of the native radial head, which is the primary goal of the procedure.
Step 6: Stem Broaching Sequentially broach the canal until good cortical contact is achieved and undersize the definitive stem by 1 mm to allow implant movement within the canal and appropriate articulation with the capitellum.
Step 7: Insertion of Trial Components and Final Radial Head Implant With the selected trial in place, assess the radial head diameter, height, and articular congruency.
Step 8: Closure and Repair of the LCL Ensure proper repair of the LCL as it is essential to maintaining or restoring elbow stability.
Step 9: Postoperative Protocol Postoperative rehabilitation depends on the status of the collateral ligaments.
Results In a review of the cases of 55 patients at a mean follow-up of 8 years after radial head arthroplasty with a …
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