Orthopedic Radial Head Implants Surgical Techniques

🦴 ORTHOPEDIC RADIAL HEAD IMPLANTS

🔧 SURGICAL TECHNIQUE (RADIAL HEAD ARTHROPLASTY)

Radial head implants are used to restore elbow stability, forearm rotation, and load transmission, especially in comminuted radial head fractures.

1. 📋 Preoperative Planning

Indications

• Comminuted radial head fractures (Mason Type III/IV)

• Non-reconstructable fractures

• Elbow instability (ligament injury)

• Fracture-dislocations

Clinical Evaluation

• Assess:

  • Range of motion

  • Stability of elbow

  • Neurovascular status

Imaging

• X-ray (AP & lateral elbow)

• CT scan (complex fractures)

Planning Considerations

• Implant type:

  • Monoblock or modular

• Determine:

  • Radial head diameter

  • Stem size

  • Head height

👉 Accurate sizing is critical to avoid overstuffing or instability.

2. 🛏️ Patient Positioning & Setup

• Supine or lateral position

• Arm placed on arm board

• Tourniquet applied

• Regional/general anesthesia

• Sterile draping

3. 🔪 Surgical Approach

Lateral (Kocher Approach)

• Interval between:

  • Extensor carpi ulnaris (ECU)

  • Anconeus

Steps:

1. Skin incision over lateral elbow

2. Dissect through subcutaneous tissue

3. Protect posterior interosseous nerve (PIN)

4. Incise capsule

👉 Provides excellent exposure to radial head.

4. 🦴 Radial Head Excision

Steps:

1. Identify fractured radial head

2. Remove fragments

3. Preserve radial neck

👉 Ensure complete removal of loose fragments.

5. 🪛 Radial Canal Preparation

Steps:

1. Identify medullary canal

2. Use broaches/reamers:

   • Sequential sizing

3. Prepare canal for stem

Key Points:

• Maintain correct alignment

• Avoid cortical perforation

6. ⚙️ Trial Implant Placement

Steps:

1. Insert trial stem

2. Attach trial head

3. Reduce joint

Assess:

• Elbow stability

• Range of motion

• Radiocapitellar alignment

👉 Avoid:

• Overlengthening (overstuffing)

• Undersizing (instability)

7. 🔩 Final Implant Insertion

Stem Fixation:

• Press-fit (cementless) OR

• Cemented fixation

Steps:

1. Insert final stem

2. Attach radial head component

3. Ensure proper seating

8. ⚖️ Reduction & Stability Check

Assess:

• Elbow flexion-extension

• Pronation-supination

• Valgus/varus stability

Confirm:

• Smooth articulation with capitellum

• No impingement

9. 🧷 Ligament Repair (if required)

• Repair:

  • Lateral collateral ligament (LCL)

• Use suture anchors if needed

👉 Essential for elbow stability.

10. 🧼 Wound Closure

• Irrigation

• Capsule repair

• Layered closure

• Sterile dressing

11. 🏥 Postoperative Protocol

Immediate Care

• Immobilization (short period)

• Pain management

Rehabilitation

• Early controlled mobilization

• Avoid stiffness

• Gradual strengthening

12. ⚠️ Complications & Prevention

Complication Prevention

Overstuffing

Correct implant sizing

Instability

Proper ligament repair

Stiffness

Early mobilization

Implant loosening

Stable fixation

Nerve injury (PIN)

Careful dissection

13. 🔓 Implant Removal / Revision

Indications:

• Loosening

• Pain

• Malposition

14. ✅ Key Surgical Principles

• Restore radial length and alignment

• Avoid overstuffing the joint

• Ensure smooth articulation

• Preserve soft tissue structures

• Achieve stable fixation

🌟 Advantages of Radial Head Implants

• Restore elbow stability

• Allow early mobilization

• Prevent proximal migration of radius

• Improve functional outcomes

📌 Conclusion

Radial head implant systems from Jindal Medi Surge provide effective reconstruction of complex elbow injuries, ensuring:

• Stable joint mechanics

• Improved mobility

• Reduced complication