Radial head replacement involves replacing the broken head of the radius bone at the elbow with a metal implant. It is performed when a radial head fracture is too badly damaged to be fixed with screws.
An incision is made over the outer side of the elbow. The shattered radial head is removed and replaced with a smooth metal prosthesis that is press-fit into the remaining bone. This restores the stability of the elbow and forearm. The operation usually takes 45–90 minutes.
Replacement is recommended when the radial head is fractured into multiple fragments that cannot be reliably fixed with screws (a comminuted fracture), particularly when elbow stability depends on preserving the radial head.
Simple radial head fractures are usually managed without surgery — with a sling, pain relief, and early movement. If the fracture can be fixed with screws (open reduction internal fixation), this may be preferred over replacement. Complete removal of the radial head (excision) without replacement is sometimes an option but may lead to elbow instability.
Surgery is usually performed within days of the injury. Standard pre-operative assessment and fasting are required.
The aim is to restore elbow stability, allow early movement, and prevent long-term complications of radial head loss such as elbow instability and wrist pain. Most patients regain good function, though some loss of rotation is common.
Some loss of full extension and rotation is common after elbow fractures.
Unwanted bone formation around the elbow that can limit movement.
Expected in the early weeks after surgery.
The replacement may loosen over time, particularly with heavy use.
The posterior interosseous nerve is at risk. Temporary weakness of finger extension is uncommon.
Wound or deep infection around the implant.
If associated ligament injuries are not adequately addressed.
General anaesthesia with or without a regional arm block for post-operative pain relief.
Early movement is critical to prevent stiffness. A sling is used for comfort initially but gentle exercises start within a few days. Physiotherapy guides the rehabilitation. Most patients return to light activities within four to six weeks. Full recovery takes three to six months. Some loss of elbow extension or rotation is common.
Wound review at two weeks. X-rays and surgeon review at six weeks and three months to monitor healing and implant position.
In many patients the implant functions well long-term. If it loosens or causes problems, it can be revised or removed once the ligaments have healed.
Most patients regain a functional range of motion. Some loss of full extension and rotation is common after radial head fractures.