Short- to medium-term outcomes of radial head replacement arthroplasty in posttraumatic unstable elbows: 20 to 70 months follow-up.

Background: The radial head is considered the main stabilizer of the elbow when the medial collateral ligament and lateral ulnar collateral ligament have been compromised. Radial head replacement (RHR) is indicated for patients with irreparable or non-united radial head fractures associated with elbow stiffness or instability. The present study aimed to analyze the clinical results after treatment with titanium radial head prostheses, repair of torn soft tissue constraints, and early mobilization of the elbow.

Methods: From 2002 to 2008, 13 patients with radial head fractures were included. RHR arthroplasty was performed primarily for irreparable fractures in 10 patients and secondarily for radial head fracture nonunion in 3. All patients were followed-up clinically and radiographically for a mean of 38 months (range, 20 to 70 months).

Results: On the basis of Mayo Elbow Performance Scores, 8 patients had excellent results; 3, good results; and 2, fair results. No patient had elbow instability after RHR. Two patients had elbow stiffness 6 months after RHR and underwent surgical intervention for contracture release. None of the prostheses were removed because of loosening or infection.

Conclusion: Treatment of irreparable radial head fractures with a modular titanium radial head prosthesis and soft-tissue reconstruction yields satisfactory results. Early mobilization of the elbow is important for the restoration of elbow range of motion and function.