A radial head fracture occurs at the upper end of the radius – one of the bones in the forearm. Fracture of the radial head is relatively common where people have fallen on an outstretched hand – causing elbow instability or elbow fracture. A radial head fracture does not always mean that it must be replaced, but where it is badly fractured and / or dislocated, a replacement is generally the recommended treatment.
Some bone fractures require immediate medical attention and so the following guidelines may not apply to emergency admissions.
- Existing medication(s) – some medications can impact surgery, especially any anti-coagulant medication and medicine for diabetes; we will advise if any of your medication needs to be stopped (and when) well ahead of the day of surgery. Any other medication should be taken the morning of surgery with a little water (half a cup maximum).
- You should not shave (or wax) skin near where any surgical incisions will be made.
- No solid foods (cow's milk and drinks containing cow's milk are considered food) should be consumed within 6 hours of surgery; clear fluids (e.g. water, cordial) may be consumed until 3 hours before surgery and then nil by mouth from that point.
- Please advise us if you have a cold or fever, a cough or any other injuries or infections (e.g. urinary tract infection or cuts/tears to the skin) – your procedure may need to be postponed as any of these may make anaesthesia or surgery unsafe.
- Please bring all imaging (e.g.x-rays / CT scans / MRI scans) with you to hospital.
- Please come to hospital at least one hour before your planned surgery, unless we advise you otherwise.
In very general terms make sure you follow a healthy and balanced diet before surgery and continue any regular physical activity up until the day of the procedure. If you smoke, you should ideally stop smoking at least four weeks before the procedure and otherwise as a minimum at least one week before.
A radial head replacement procedure is conducted under a general anaesthetic and involves a 5-7cm incision to the side of the elbow or the front of the forearm. Bone fragments are carefully removed, and the radial neck is prepared for the fitting of the prosthetic joint, which is normally made either of cobalt chrome or a lighter pyrocarbon.
The correct joint size is selected and fitted and implanted into position. It is then checked for stability and correct movement before the incision is closed. The procedure takes around 90 minutes.
The arm is placed into a splint after surgery and patients generally have to stay in hospital overnight. Around 6-8 weeks after surgery patients start a strengthening and stretching program to combat any stiffness in the elbow and restore arm strength. Patients can generally drive again around 8 weeks after surgery and full recovery takes around 3 months. More details on the rehabilitation program will be given to you after surgery.
As with any surgery, with radial head replacement surgery there is always a risk of:
- Infection (of the incision site, or in the chest).
- Blood clot (leg or lung).
- Heart attack.
- Damage to nerves / blood vessels.
Specific risks of radial head replacement surgery include:
- Forearm deformity.
- Elbow dislocation.
- Prosthetic component failure.
- Calcification (abnormal bone formation).
- Loss of full range of movement in the arm.