Treatment of radial head fractures-literature overview

The radial head is an important stabilizer of the elbow joint. Radial head fractures are often associated with other destabilizing concomitant injuries and can lead to relevant functional limitations of the elbow. Depending on the injury a differentiated treatment regimen must be chosen. Non-or slightly displaced fractures can be treated conservatively in most cases. Displaced fractures are usually treated surgically. Anatomic fixation of the head fragments can be achieved by use of screws and/or plates. In recent years, technical progress has enhanced the indication for radial head osteosynthesis. In the case of non-reconstructable fractures the implantation of a radial head prosthesis is the treatment of choice. Especially with more complex fractures the treatment of associated osteoligamentous injuries is essential for a good outcome. Overall the evidence for the treatment of radial head fractures is insufficient especially for displaced and multifragmentary injuries. Low case numbers and retrospective study designs are responsible for that. Furthermore, long-term results are often missing in particular for radial head replacement. Successful treatment of radial head fractures requires anatomic reduction and stable fixation of the articular surface, allowing early active motion and minimizing the risk of secondary degenerative changes.