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.

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.