Radial head fractures and the role of radial head prosthetic replacement: current update.

Radial head fractures are often secondary to a direct axial force, such as that involved in motor vehicle accidents and falls on an outstretched hand. The Hotchkiss-modified Mason classification is an excellent assessment tool in that it provides commonly accepted direction regarding treatment. For more unstable, comminuted displaced radial head fractures that cannot be reconstructed, replacement of the radial head is warranted. The surgeon should attempt open reduction and internal fixation with restoration of the radial head in anatomical alignment for most type II and some type III fractures, and this treatment is recommended over radial head resection without replacement, as the latter is associated with both elbow and forearm instability over the long term and should be avoided. New radial head replacement designs, including bipolar designs and radial head and capitellar replacements, are available but have limited reported clinical results.