Replacement of the radial head in the treatment of unstable elbow fractures

Abstract

The use of a radial head prosthesis for the treatment of fractures of the radial head associated with gross instability of the elbow is described. Seventeen fractures occurring in seventeen patients treated at the Toronto East General Hospital from 1966 to 1979 are analysed. Instability of the elbow occurs when fracture of the radial head is combined with dislocation of the elbow, fracture of the proximal ulna, fracture of a major portion of the coronoid process and rupture of the medial ligament. Stability can be restored in these injuries by inserting a radial head prosthesis which acts as a joint spacer. A metallic prosthesis was used in 15 patients and a silastic cap in 2. The results of this method of treatment for a difficult problem are good. We are not advocating the routine use of a prosthesis for simple fractures of the radial head. It is indicated for injuries where stability is poor after excision of the radial head. There is little information in the literature regarding the use of a prosthesis for radial head fractures.