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When is radial head replacement necessary?

Radial head replacement is a type of surgery that replaces an injured or damaged radial head with an artificial joint prosthesis. The radial head is an essential part of the elbow that enables its motion during bending and straightening of the joint as well as rotating the forearm.

When it becomes injured or suffers damage, it can impact the complete movement capabilities of the elbow and result in the need for a replacement radial head. In this guide, we’ll be exploring the exact circumstances in which radial head replacement surgery is needed and other key details you need to know about the procedure.

 

What are the symptoms of an injured or damaged radial head?

The radial head can be injured by a serious fracture or become damaged over time as a result of degenerative conditions like arthritis. If you have an injury or condition that is causing damage to the radial head, you will likely experience a lot of pain in the elbow, crepitation, and decreased motion and functionality in the joint.

 

What happens during a radial head replacement?

Radial head replacement surgery is performed under general anaesthetic, the surgeon will start by making an incision on the outside of the elbow joint. They will then move tendons and ligaments out of the way to expose the radial head. Once exposed, the surgeon can remove the damaged bone and prepare to fit the artificial implant. The implant will replicate the head and have a long metal stem. Each person’s bones will be different, which makes accurate sizing essential to choosing the right artificial implant for the patient’s anatomy.

ALIGN Radial Head Replacement

The ALIGN radial head from Skeletal Dynamics is a highly effective prosthesis that works to achieve as close to the patient’s natural anatomy as possible. It has a wide range of impressive features and simple instrumentation that ensure it generates the best possible outcomes for the patient, ensuring pain-free stability and a better range of movement. These features include:

  • Side loading head with several stem and neck side options.
  • Customised monoblock that aligns to the patients’ anatomy
  • Long, press-fit design
  • Digital stem flutes

This clinical paper, from 2022 demonstrates how the Align’s anatomical design, which is aligned to the patients’ axis of forearm rotation, produces satisfactory results across multiple surgeons and institutions.

Contact us today if you’d like more information about the ALIGN System.

 

When is radial head replacement needed?

Radial head replacement surgery is the best course of action if the radial head has been fractured so severely that it cannot be repaired via internal fixation. This is the only way to effectively restore as much mobility as possible to the elbow. Radial head replacement can also be used in certain cases of inflammatory arthritis.

Radial head fracture

The most common cause of a radial head fracture is falling directly onto an outstretched hand, which is why it is an injury that is frequently found in those who play fast and vigorous sports. Replacement surgery can offer relief from fracture symptoms like stiffness, pain, and swelling as well as the limitations in movement and function of the elbow. Not all radial head fractures will require replacement surgery.   LEDA Orthopaedics supplies the Skeletal Dynamics Distal Elbow Set, which includes the Align® radial head replacement as well as the Protean Radial Head Plate and the Reduct Headless Compression Screws. These options can also be considered for treatment of radial neck fractures and reconstructible (less comminuted) radial head fractures.

If the proximal radius is not displaced (meaning it’s still in the same position) then it can be treated by immobilisation and then physiotherapy. If the fracture is displaced, then it will likely need to be repositioned and stabilised with screws or pins. Both of these instances are when a more conservative treatment approach can be taken. However, for severe fractures, when it is displaced, comminuted (there are 3 or more bone fragments), and if the radial head has been irreversibly damaged, replacement surgery is typically the best treatment option. LEDA Orthopaedics also supply the patient-friendly eXo Splint, which may be a useful option for elbow fracture patients.

Arthritis

Again, not all cases of arthritis will require radial head replacement, it is a significant surgical procedure that isn’t carried out lightly. An example of when replacement could be the best treatment option is when the articular cartilage that covers the radial head becomes damaged due to serious inflammatory arthritis.

This type of cartilage damage can cause substantial pain and stiffness and limit the functionality of the joint. If the damage is severe, radial head surgery could be the appropriate treatment to ease the patient’s symptoms and help them get back to normal daily activities which may have previously been restricted by the arthritis.

 

Conclusion

Overall, radial head replacement is a necessary treatment in instances of severe and complex fractures and degenerative conditions like inflammatory arthritis. As a leading UK orthopaedic distributor, we understand the importance of providing innovative and effective medical solutions to orthopaedic surgeons that will support them and their patients in treating elbow trauma conditions. Explore more of the Skeletal Dynamics elbow and upper extremity products we supply online today.

December, 2023
Elsevier non solus
What’s the difference between a comminuted fracture and a transverse fracture?

Although fractures are a common injury, there are many different kinds depending on how the bones break. Different types of fracture must be addressed in a way that is appropriate to the trauma suffered and the area that has been affected. Oftentimes, severe fractures will need orthopaedic trauma surgery to ensure proper recovery. As such, devices are designed specifically to treat fractures of a certain type or fractures to a certain area of the body.

In this blog, we differentiate between two of the most common fractures, their causes, and how they should be treated.

 

Comminuted fractures

A comminuted fracture is a particularly serious type of injury where the bone breaks in multiple places. This produces several bone fragments that separate from the main bone structure. The primary cause of comminuted fractures is a high-impact event that results in severe trauma, such as a car accident.

Comminuted fractures that occur in key articular locations can be especially damaging for a patient’s range of movement.  If appropriate, specialist internal fixation and open reduction surgery is the best course of action to treat these fractures. For instance, the Align® Radial Head Replacement system has been designed to treat non-reconstructable, highly comminuted radial head fractures, while the Reduct® Headless Compression Screws can be used to piece together less comminuted fracture injuries of the radial head.

The advantage of LEDA’s Skeletal Dymamics Distal Elbow Set is that both the Align and the Reduct are available on the same kit, so the surgeon can make the choice between systems intraoperatively. The recovery time for surgeries to repair comminuted fractures varies depending on the bone that has been broken, along with other patient-specific factors. This market-leading supplier also have dedicated systems for the treatment of fractures elsewhere in the upper extremities, such as their FREEFIX® Forearm and Wrist Plating System.

 

Transverse fractures

A transverse fracture is a break in the bone that occurs perpendicular to the length of the affected bone. These fractures typically appear as a line that covers all or part of the bone’s circumference. Transverse fractures are more common in longer bones, such as the humerus, radius, tibia, and ulna. Transverse fractures are usually caused by trauma due to a fall. Nevertheless, surgery is frequently used to aid healing as the bones that often experience these fractures are responsible for important body movements.

Either of the fractures discussed here can vary depending on the displacement of the fractured bone. These categories are:

  • Open – a wound that breaks the skin has been caused near the fracture site, often by a bone fragment.
  • Closed – a break occurs in the bone that keeps the skin intact.
  • Displaced – the fracture causes the affected bone to move out of its proper alignment.
  • Non-displaced – the fracture leaves the bone in its accepted position, which allows it to heal without invasive measures.

 

Devices for fracture reduction and fixation

Comminuted and transverse fractures can affect anyone regardless of age or anatomy. As such, medical professionals need to be prepared to treat either throughout the year. LEDA Orthopaedics distributes systems and implants which have been designed by healthcare experts for the treatment of a variety of fractures. This includes trauma to the upper and lower extremities, as well as the ability to treat niche and complex injuries such as pelvic fractures. Contact us today if you have any questions about our product specifications, instrumentation or storage information.

December, 2023
Elsevier non solus
Align Publication

52 Align cases across 6 surgical centres, with an average follow up of 50 months.

Results show great patient satisfaction and no loosening

Read Full Clinical Data

April, 2022