Radial Head Fractures

Treatment of radial head fractures centers around the distinction of stable, nondisplaced or minimally displaced fractures, and those with significant displacement, which are usually part of a greater pattern of injury. Treatment of stable injuries is aimed at achieving osseous union while preventing stiffness and can usually be accomplished with nonoperative means. Operative treatment of isolated radial head fractures is indicated if significant displacement or mechanical block to motion is observed. Options for surgical treatment include open or arthroscopic techniques as well as a myriad of other options including fragment or whole-head excision, internal fixation with headless compression screws, or plate-and-screw constructs as well as prosthetic replacement. Treatment of displaced or unstable fractures centers on restoration of the radiocapitellar contact and repairing other soft tissue injuries, which are necessary to stabilize the elbow. Radial head arthroplasty should be considered in situations where 3 or more fragments of the radial head exist, with the use of various intraoperative methods to ensure restoration of the lateral elbow anatomy.