Radial Head Arthroplasty for Comminuted Fracture

Master the radial head arthroplasty, an important procedure for multifragmentary fractures. This training offers a technical immersion in the lateral approach via the Kaplan interval, focusing on uncemented prosthetic replacement, maximum preservation of the radial neck, and restoration of elbow stability and range of motion.

Training Focus:

• Radial head arthroplasty for multifragmentary fractures..
• Lateral approach via the Kaplan interval.
• Uncemented prosthetic replacement focusing on the preservation of the radial neck.
• Restoration of elbow stability and range of motion.
• Ligament reconstruction and anatomical closure.

Detailed Content:

• Surgical Access and Exposure: Lateral approach with Kaplan interval, dermographic markings on the lateral epicondyle. Access through planes with hemostasis. Multifragmanted fracture requiring prosthesis. Opening of the annular ligament and osteotomy with preservation of the radial neck.
• Preparation of the Medullary Canal: Cushion under the elbow for discreet varus. Manual milling with close adjustment to the medullary canal for a good fit of the uncemented implant.
• Testing and Regulation of the Osteotomy: Testing the diameter of the implant with manual rotation of the arm/hand. Preference for a smaller diameter in case of doubt.Regularization of the osteotomy and use of a test component according to the measurement of the radial head.
• Final Implant: The implant must align with the articular surface of the olecranon. Adjustments to the osteotomy, compaction of the component with a hammer. Movement testing without blockages after reduction.
• Closure and Ligaments: Closure in layers. Suture of the annular ligament with extension and valgus for ideal tensioning. Reinsertion of the lateral collateral with an anchor, maintaining extension and valgus when fixing.
• Optimized Results: Closure with preserved musculature. Free elbow movements. X-rays should confirm joint preservation and appropriate size of the radial head. Aligned marks for final aesthetics.