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Radial head replacement

Radial head replacement is a common procedure for people who have sustained elbow injuries.  

Radial head replacement

Radial head replacement is a common procedure for people who have sustained elbow injuries. 

Radial head replacement

What is radial head replacement?

Radial head replacement is a procedure that removes fractured bone in the elbow and replaces it with an artificial implant. The goal is to reduce elbow instability which can cause ongoing pain and discomfort. This is especially important for patients with injuries that would not respond well to reduction or internal fixation. This type of surgery is fairly common, as approximately one in five traumatic elbow injuries involve radial head fractures, especially amongst women in their thirties.

As a fairly common result of direct and indirect trauma, radial head fractures are also extremely painful. Symptoms of a radial head fracture include pain and swelling of the elbow joint, making it difficult to turn, bend, or straighten the arm. If you have a radial head fracture, you may experience a simultaneous fracture of the capitellum on the inside of the elbow, and notice a visible deformity or dislocation of the joint. 

The process of diagnosing radial head fractures is done first by physical examination. Your doctor will be able to detect evidence of a fracture more effectively than an X-ray. In order to determine the appropriate course of treatment, your doctor will assess the size and severity of the fracture and displacement in the bone. Pressure is applied to the joint to test the stability of the joint and surrounding tissues. If the pieces of bone in the radial head remain intact, the fracture may not require surgery.

The best treatment for a radial head fracture depends on the severity of the break. Cracks in the bone that have not caused separation often respond well to non-surgical treatment using a splint and a sling. However, if the bones in the elbow are badly broken or displaced, especially into multiple pieces, surgery may be the only option. In this case, the bones will be surgically removed or repositioned, and if necessary, an artificial bone replacement may be inserted.

Immediately after the surgery, you should expect to experience some discomfort and swelling in and around the elbow joint. The good news is that most patients recover from the majority, if not all, of these symptoms within approximately six months. The results of the radial head replacement surgery last approximately 10 years as as the artificial bone implant will require replacing. Despite this, the value of pain-free movement to quality of life is enough to justify the surgery for many patients.

Whilst the majority of people who undergo elbow surgery do well and are very happy with their results, there are risks which are specific to elbow surgery in addition to the general risks of surgery. This includes deep infection, injury to the nerves tendons or blood vessels close to the surgical field which may require further surgery, stiffness or loss of motion, developing abnormal bone formation such as heterotopic ossification or myositis ossificans, ongoing pain, instability, fracture of the bones and abnormal pain responses such as Chronic Regional Pain Syndrome (CRPS). 

Most of these risks are low and less than 5% but stiffness is not uncommon but usually resolves with time with physiotherapy. It is important to be aware of these risks before consenting to surgery. There are also risks relating to the specific type of elbow surgery that you are having, which Dr Cheriachan will discuss with you in detail during your consultation.

Following a period of immobilisation in a splint, rehabilitation typically consists of up to six months of physical therapy and rehabilitative exercises. Beginning with exercises for range of motion and working up to strength activities. Your course of physiotherapy may take three to four months depending on your progression, your commitment to the exercises, and the severity of your original injury. All of this is vital to prevent the elbow joint from becoming stiff.

Preparing for your visit

Dr Cheriachan consults from Norwest on Wednesdays and Blacktown on Mondays and Thursdays.

Your first visit will be used to carefully assess your condition as well as gathering all related health information. It is important that you bring all relevant documents including scans and x-rays. We also ask that you wear clothing that allows freedom of movement as your visit will include a physical examination. 

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