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Chapter 25 Video 1: Radial Head Arthroplasty

July 02, 2016

Contributors: Graham J W King, MD

This video is demonstration of a radial head arthroplasty in a 51 year old female. Radiographs show a comminuted displaced radial head fracture with fragments extruded posterior to the capitellum. Fluoroscopy is performed under anesthesia, and a valgus stress test reveals medial collateral ligament disruption with an intact lateral collateral ligament. The patient is placed in a supine position, and a posterior incision is used. Intervals are identified, and common extensor tendon splitting technique is used to expose the joint. The annular ligament is divided anterior to the lateral ulnar collateral ligament. The radial head fragments are judged not to be repairable. The fragments are removed and sized in a template. The radial head is elliptical so the minor dimension is chosen as the correct diameter. The thickness of the implant is selected based on the height of the excised fragments. The radial neck is rasped and reamed. The radial head and stem implants are trialed; the implant should articulate at the level of the proximal radioulnar joint, 2mm distal to the tip of the coronoid. The prosthesis is assembled then inserted into the proximal radius. The joint is brought through a full range of motion, and the fit and articular tracking is confirmed both visually and  fluoroscopically. The annular ligament and extensor digitorum communis split are repaired, and closure is performed.  The end results are shown radiographically.

Results for "Advanced Reconstruction: Elbow 2"