Radial head arthroplasty: state of the art.

Radial head arthroplasty has joined the armamentarium of options for the treatment of complex radial head fractures, elbow instability, and arthritic conditions. A variety of implants has been introduced in the past decade; these differ in metallic composition, design, and method of fixation. Good short- and intermediate-term outcomes have been reported with the use of loose-fitting prostheses. Press-fit devices restore stability and improve pain and motion but are associated with a greater likelihood of implant loosening, leading to revision surgery. Postoperative elbow stiffness, pain, ulnar nerve palsy, posterior interosseous nerve palsy, and heterotopic ossification have all been reported following radial head surgery, but these complications are likely related to the trauma sustained by the elbow. Adequate knowledge of the surgical indications, types of implants, and surgical technique are essential for a satisfactory outcome when a radial head prosthesis is used for the treatment of nonreconstructable radial head fractures.