This study evaluated the early results of titanium radial head implants for comminuted radial head fractures. Twenty-five elbows in 24 patients were evaluated at a mean of 39 months. Twenty-three radial head fractures were associated with other elbow fractures and/or dislocations necessitating 52 other simultaneous elbow procedures. The Mayo Elbow Performance Index rated 3 elbows rated as poor, 5 fair, and 17 good or excellent. Subjective patients satisfaction averaged 9.2 (1-10 scale). Elbow range of motion averaged extension 8 + 7 degrees to 140 + 9 degrees, pronation 78 + 9 degrees and supination 68 + 10 degrees. Common radiographic findings included bone lucencies surrounding the implant stem, progressive bone loss at the base of the radial head implant and capitellar osteopenia.
Considering that this study included so many concomitant injuries and provided only relatively short-term follow-up for a metallic implant, it is difficult to form many conclusions related specifically to radial head prostheses. It does confirm that metallic radial head implants are relatively safe to use in the short-term. They aid in ulnohumeral instability following trauma and may help provide longitudinal stability to the forearm axis with interosseous membrane disruption, although this is yet to be proven. Clearly many questions still remain, such as the long-term sequellae of the periprosthetic lucencies.