Hand clinics
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There are two main goals for the surgeon treating injuries around the elbow joint: the maintenance of a stable, concentric reduction of the joint and the initiation of early motion to help prevent stiffness and maximize functional out-come. The presence of a fracture decreases joint stability and increases the risk for early subluxation or dislocation with motion. Operative repair thus is indicated for most of these injuries to restore sufficient osseoligamentous support to allow safe, early motion and provide a stable functional elbow in the long term.
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Radial head arthroplasty is indicated for displaced comminuted radial head fractures that cannot be managed reliably with open reduction and internal fixation and that have an associated elbow dislocation. Replacement also is indicated in patients with comminuted radial head fractures that have or are likely to have a disruption of the medial col-lateral, lateral collateral, or interosseous ligaments. ⋯ The early and midterm clinical experience with metallic radial head arthroplasty has been encouraging relative to earlier reports with silicone devices. Newer modular designs incorporate improved sizing to better reproduce the anatomy of the proximal radius and are easier to insert intraoperatively.