Management of radial head fractures with implant arthroplasty

Although most radial head fractures can be managed nonsurgically or with open reduction and internal fixation, some are comminuted and cannot be treated successfully with these options. Radial head arthroplasty is indicated for unreconstructable displaced radial head fractures with an associated elbow dislocation or disruption of the medial collateral, lateral collateral, or interosseous ligaments. Metallic radial head implants have been shown to have superior resistance to valgus and axial stresses relative to silicone implants in biomechanical studies. The clinical experience with metallic radial head arthroplasty to date has been encouraging relative to earlier series with silicone devices. Newer modular prosthesis designs are easier to implant and incorporate improved sizing to better reproduce the anatomy of the proximal radius. Advances in implant design and materials can be expected to further improve the durability of these devices in the future.