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桡骨头骨折 资料

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会在肘部外侧感到剧烈疼痛。这正是桡骨头所在的位置。疼痛通常会向下放射至前臂，或向上蔓延至肩部。您还可能会注意到关节周围出现肿胀和瘀伤。这些症状在跌倒或直接撞击后很常见。

每次弯曲或伸直手臂时，疼痛可能会加剧。扭转动作通常最为困难。转动门把手、使用螺丝刀或提起购物袋都可能导致不适感突然加剧。您可能会发现很难将手掌向上或向下旋转。简单的任务，如将衬衫塞进裤腰或伸手到背后扣内衣，也会变得困难。您可能会本能地将手臂贴近身体以保护它。

将手臂放在枕头上通常有助于减轻关节压力。然而，让肘部完全静止过久可能会导致关节感觉僵硬和紧绷。您可能会在夜间因疼痛搏动或无法找到舒适的姿势而醒来。通常无法在受伤的一侧侧卧睡觉。即使仰卧，如果手臂垂向一侧，也可能感到疼痛。

症状的严重程度取决于骨骼移位的程度。如果骨折稳定，您可能只需通过止痛和适度活动即可应对。如果骨碎片发生移位，疼痛将更加剧烈且持续。您在活动肘部时可能会感到咔哒声或摩擦感。这是因为断裂的骨片相互摩擦所致。

让外科医生评估损伤程度非常重要。他们将确定骨折是简单还是复杂。这有助于我们决定您是否需要手术，或者保守治疗是否足够。不要试图忍痛坚持。倾听身体的信号，避免引起剧烈不适的活动。早期护理有助于预防长期僵硬，并确保肘部以最佳位置愈合。

实际发生了什么

您的肘关节是一个由三块骨头在一个关节处交汇而成的复杂铰链结构。桡骨头是前臂骨圆形的顶部，充当减震器和肘关节侧面的稳定器。当您手掌撑地摔倒时，这块小骨头通常会承受主要的冲击力。

在移位性骨折中，骨头断裂并偏离原位。这会破坏允许手臂旋转的光滑表面。您可能会感到肘关节外侧疼痛，因为关节的自然对线被破坏。周围组织（包括像绳索一样将关节固定在一起的韧带）也可能撕裂。这种骨折与韧带松弛的组合会导致不稳定，使您的肘关节感觉无力或可能突然失效。

如果骨头碎裂成许多碎片，您的外科医生必须决定是修复还是置换。当骨头损坏严重无法修复时，金属桡骨头植入物可以恢复其减震功能。这种置换术为复杂骨折提供了可靠的疗效。在某些情况下，早期移除骨折块可使 96% 的患者在长期内获得满意的功能，尽管 X 线片上后期可能会出现磨损变化。

您受伤的严重程度取决于涉及的结构数量。简单骨折通常通过休息即可良好愈合。更复杂的损伤涉及多块骨头和韧带受损，需要仔细规划以恢复稳定性。了解这些模式有助于您的外科医生选择正确的方法，安全地恢复您的肘关节活动。

我们能做什么

您采取的治疗方案取决于您受伤的严重程度。Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 博士会根据您的具体骨折类型指导患者做出决策。大多数损伤首先需要进行休息和轻柔活动。我们的目标是减轻肿胀并保持肘关节活动度，同时避免强行活动。这种自我管理阶段通常持续数周。随着骨骼开始愈合，物理治疗有助于您恢复力量和协调性。对于许多骨折稳定且移位轻微的患者的非手术治疗路径就足够了。

如果疼痛持续存在，我们可能会讨论药物治疗方案，以帮助您在损伤恢复期间应对不适。非处方止痛药或抗炎药可以在短期内缓解不适。在某些情况下，我们可能会建议注射治疗。皮质类固醇注射可减少炎症，并提供数周的缓解。透明质酸注射旨在润滑关节，尽管其在急性骨折中使用的证据有限。富血小板血浆（PRP）注射利用您自身的血液成分来支持愈合，但结果因人而异。这些选项并非治愈手段；它们是帮助您参与康复的工具。我们会定期评估您的进展，以确定这些措施是否足够，或者是否需要采取进一步措施。

当保守治疗达到极限或骨折过于复杂而无法安全自行愈合时，会考虑手术治疗。对于超过三个碎片的移位性骨折，或骨骼粉碎（粉碎性骨折）的情况，我们推荐手术治疗。在这些情况下，我们通常用金属植入物替换受损的骨骼部分。该手术对于无法重建的骨折是安全且有效的。对于患有严重肘关节不稳（恐怖三联征损伤）的患者，我们可能会选择固定骨骼或进行置换，具体取决于哪种方式能提供最稳定的关节。在长期随访中，桡骨头置换术在 96% 的患者中取得了令人满意的functional结果。我们会与您讨论这些选项，以确保计划符合您的需求及活动目标。

预期情况

您的预后主要取决于骨折的严重程度以及肘部其他部位是否受伤。对于简单且稳定的骨折，非手术治疗通常能带来良好的长期结果。采用这种方法，并发症的风险较低。即使您的骨碎片有 2 至 5 毫米的轻微移位，手术通常也不比休息和固定带来更多益处。

如果您的骨折复杂或粉碎，您的外科医生可能会建议用金属植入物替换桡骨头。对于无法通过钢板或螺钉固定的骨折，此选项安全且有效。大多数植入此类植入物的患者都能获得良好的功能结果。长期数据显示，在早期移除或替换桡骨头后，96% 的患者结果令人满意。然而，您应该知道，术后 X 光片上出现磨损性改变很常见。尽管存在这些可见变化，您的日常功能通常仍然良好。

恢复过程因治疗路径而异。保守治疗期间，随着骨骼愈合，症状通常会缓解。手术后，您可能会随时间推移出现创伤性关节炎。这是一个已知的风险，但并不总是妨碍您良好地使用手臂。对于涉及多个肘部结构的严重损伤，移除或替换桡骨头对最终结果的影响相似。

MRI 扫描中发现的大多数其他损伤在短期内没有症状。您可能完全感觉不到它们。您的外科医生将专注于主要骨折以恢复稳定性。虽然部分患者日后可能需要翻修手术，但大多数人发现他们的恢复是可靠的。我们的目标是为您提供一个稳定的肘部，使您能够恢复正常活动。您的体验将取决于您损伤的具体性质以及对所选方案的反应程度。

何时就诊

若休息后疼痛仍持续不缓解，或感觉肘部无力及不稳，请咨询全科医生。若肘部出现交锁或打软腿，或症状干扰睡眠或工作，请要求专科医生评估。疼痛突然加重也是就医指征。及时诊断非常重要，因为延迟治疗可能导致不良预后。您的外科医生将检查前臂不稳的体征，这需要适当的初始干预。早期识别有助于避免并发症，并支持肘部获得更好的长期结果。

Reviewed by Dr Kieran Hirpara · 7 August 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • There is insufficient evidence to draw definitive conclusions on the optimal treatment of type II-IV radial head fractures [11].
  • Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence [18].
  • The challenge in the coming years is to perform high-level clinical studies to obtain consensus regarding the most appropriate treatment for comminuted radial head fractures [1].
  • Radial head replacement is recommended for comminuted fractures, with satisfactory medium- and long-term results [20].
  • Bipolar-cemented implants show lower revision rates compared to other options in radial head replacement [20].
  • Radial head implants offer a reliable treatment for complex Mason type III and IV fractures, with good functional and survival outcomes and a low incidence of complications [3].
  • Clinical outcome studies of metallic radial head arthroplasty systems indicate that head replacement is a reasonable option to offer patients with comminuted radial head fractures and complex elbow trauma [12].
  • Adequate knowledge of 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 [17].
  • The intraoperative decision to fix or replace the radial head is critical to optimize treatment outcomes [49].
  • Arthroscopic reduction internal fixation (ARIF) is a safe and viable option for treating displaced radial head fractures [23].
  • For radial head arthroplasties, acute trauma is the most common indication [14].
  • The Radial Head System is the most commonly used implant for radial head arthroplasties [14].
  • Treatment of radial head fractures may have an independent effect on outcome in terrible triad injuries (TTI) [30].
  • Reconstruction of comminuted radial head fractures is recommended in the context of a TTI, provided stable fixation can be achieved [30].
  • Overall reoperation rates are high in patients undergoing operative treatment of radial head and neck fractures [35].

Anatomy & Pathophysiology

  • Most fractures of the radial head are stable [19].
  • Displaced unstable fractures require restoration of radiocapitellar contact via reconstruction or prosthetic replacement to prevent elbow instability [19].
  • Complex fractures associated with elbow instability require careful selection between open reduction and internal fixation and arthroplasty [38].
  • The difference in radiographic height between the tip of the coronoid and anterior radial head in the normal elbow averages 5 mm [39].
  • The ligaments have the most marked influence on stability, particularly when the upper limb is positioned such that valgus and varus gravity loads are applied to the elbow [55].
  • Treatment is dictated by fracture type, stability, and ligamentous integrity [58].

Classification

  • Radial head fractures are common and frequently accompanied by associated osseous injuries [2].
  • The incidence of associated, osseous injuries of the upper limb in radial head fractures is high [15].
  • Radial head and neck fractures have distinct epidemiological characteristics [13].
  • Consideration for osteoporosis in a subset of patients with radial head and neck fractures is recommended [13].
  • Complications of radial head fractures are characteristic to their classification [4].
  • It is important to determine which structures need to be repaired in isolated displaced type II partial articular radial head fractures to avoid complications that could lead to elbow instability [7].
  • Conservative management is indicated for type 1 radial head fractures [52].
  • Open reduction and internal fixation (ORIF) is indicated for type 2 radial head fractures with mechanical block [52].
  • Arthroplasty or resection is indicated for type 3 radial head fractures, particularly with ligamentous injury [52].
  • Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can be given with the best available evidence [18].
  • The absence of cortical irregularity in the transition zone of the radial head and neck can be used to correctly identify a non-fractured radial head [10].
  • A computed tomography–based algorithm for the management of radial head and neck fractures is provided by the Proximal and Articular Radial fractures Management (PARMa) classification [33].

Clinical Presentation

  • Radial head fractures are common injuries [2].
  • Radial head fractures are frequently accompanied by associated osseous injuries [2].
  • Injuries concomitant to radial head fractures were present in 11% of patients [6].
  • The risk for associated injuries increases with age [6].
  • Associated injuries must be considered carefully when treating radial head fractures [5].
  • When a radial head fracture is present, the wrist should be carefully examined for a scaphoid fracture [26].
  • When a scaphoid fracture is present, the wrist should be carefully examined for a radial head fracture [26].
  • Ultrasound imaging is an effective method for diagnosing occult fractures of the radial head or neck when initial radiograms show only intraarticular effusion [27].
  • Cortical irregularity in the transition zone of the radial head and neck is a reliable radiographic sign of an occult radial head fracture [10].
  • The absence of cortical irregularity in the transition zone can be used to correctly identify a non-fractured radial head [10].
  • Apparently isolated, stable partial fractures of the radial head are infrequently displaced [24].
  • Observers have moderate disagreement regarding the diagnosis of displacement in apparently isolated, stable partial fractures of the radial head [24].
  • Displacement of apparently isolated, stable partial fractures of the radial head is likely overdiagnosed [24].
  • Long-term patient-reported outcomes are excellent following nonoperative management of isolated stable fractures of the radial head or neck [8].
  • Conservative management of isolated Mason II radial head fractures yields favorable therapeutic outcomes with a low incidence of complications [16].
  • In terrible triad injuries, the imaging appearance of radial head fractures has no measurable influence on treatment recommendations [29].

Investigations

  • The complications of radial head fractures are characteristic to their classification [4].
  • Radial head fractures should be viewed as osteoligamentous lesions rather than merely osseous lesions [51].
  • It is important to determine which structures need to be repaired to avoid complications that could lead to elbow instability [7].
  • When a radial head fracture is present, the wrist should be carefully examined for a scaphoid fracture, and vice versa [26].
  • Radial head fractures in women aged 50 years are potentially osteoporotic fractures [22].
  • Subsequent radiographs during nonoperative treatment of isolated radial head or neck fractures were unhelpful and might contribute to overtreatment [9].
  • Ultrasound imaging proved to be an effective method for diagnosing occult fractures of the radial head or neck when initial radiograms showed only intraarticular effusion [27].
  • Because apparently isolated, stable partial fractures of the radial head are infrequently displaced and observers have moderate disagreement regarding the diagnosis of displacement, it is likely that displacement is overdiagnosed [24].
  • There is a positive association between radiographic findings and patient symptoms for postoperative complications after radial head arthroplasty, validating radiography as the preferred postsurgical modality of imaging [50].
  • Anatomic radial head replacement has a risk of radiographic technical mistakes that correlate to poorer outcomes [53].
  • There are significant radiographic differences between two frequently used radial head arthroplasty implants [60].

Treatment

Non-Operative Management

  • Nonoperative management of isolated stable radial head or neck fractures yields excellent long-term patient-reported outcomes [8].
  • Most fractures of the radial head are stable and managed non-operatively with good long-term results [19].
  • Most radial head fractures can be managed nonsurgically with early motion [38].
  • Nondisplaced and minimally displaced radial head fractures can be treated non-operatively with early mobilization [41].
  • ORIF and nonoperative treatment of isolated Mason type II radial head fractures provide comparably satisfactory functional outcomes, without significant differences [54].

Operative Management: Indications and General Considerations

  • A treatment algorithm for radial head and neck fractures was provided by the Proximal and Articular Radial fractures Management (PARMa) classification [33].
  • There is insufficient evidence to draw definitive conclusions on optimal treatment of type II-IV radial head fractures [11].

Radial Head Arthroplasty (RHA)

  • For radial head arthroplasties, acute trauma is the most common indication and Radial Head System the most commonly used implant [14].
  • 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 [17].
  • The management of acute unreconstructable fractures of the radial head in unstable elbow injuries with radial head replacement has a high risk of reoperation, with the peak risk appearing within 1 year after implantation [37].
  • This study suggests that RHA is the best treatment of choice for efficacy and safety in the treatment of comminuted radial head fracture [42].
  • Treatment of radial head fractures may have an independent effect on outcome; the authors recommend reconstruction of comminuted radial head fractures in the context of a terrible triad injury (TTI), providing stable fixation can be achieved [30].

Open Reduction and Internal Fixation (ORIF) and Arthroscopic Reduction Internal Fixation (ARIF)

  • ARIF is a safe and viable option for treating displaced radial head fractures [23].
  • This study suggests that RHR is the safest choice to minimize postoperative complications and enable patients to perform all daily life activities [42].

Pediatric Radial Neck Fractures

  • Thirteen percent of patients with radial neck fractures require operative treatment, 21% of which heal with fair or poor outcomes [21].

Complications

  • Thirteen percent of patients with radial neck fractures require operative treatment [21].
  • Twenty-one percent of pediatric patients with radial neck fractures who undergo operative treatment heal with fair or poor outcomes [21].
  • Long-term patient-reported outcomes were excellent following the nonoperative management of isolated stable fractures of the radial head or neck [8].
  • Bipolar-cemented implants show lower revision rates than other types of radial head replacement [20].
  • Radial head arthroplasty for fractures has a high potential for reoperation within the first year [25].
  • Survival rates with uncemented implants remain high at 10 years despite any need for reoperation [25].
  • Patients report excellent Quick Disability of the Arm, Shoulder, and Hand scores at long-term follow-ups despite any need for reoperation [25].
  • Long-term outcomes for radial head arthroplasty are satisfactory [31].
  • There is a high complication and revision rate for monopolar radial head replacement [31].
  • Implant survival of monopolar radial head replacement is 75.1% at 18 years [31].
  • The highest annual failure rate for monopolar radial head replacement is observed in the first postoperative year [31].
  • Midterm outcomes of EVOLVE radial head prosthesis are satisfactory [32].
  • Associated complication rates for EVOLVE radial head prosthesis are low [32].
  • Radial head replacement had better elbow function and fewer adverse events than ORIF for Mason type III radial head fractures in the short term [34].
  • Concomitant elbow fractures or dislocations do not affect the longer term outcomes of patients with unreconstructable radial head fractures requiring radial head arthroplasty [36].
  • Overlengthening of the radial column is a complication of radial head replacement [47].

Recovery

  • Most radial head fractures are stable and managed non-operatively with good long-term results [19].
  • Conservative management of isolated Mason type II radial head fractures yields favorable therapeutic outcomes with a low incidence of complications [16].
  • Subsequent radiographs during nonoperative treatment of isolated radial head or neck fractures are unhelpful and may contribute to overtreatment [9].
  • Radial head implants offer reliable treatment for complex Mason type III and IV fractures, with good functional and survival outcomes and a low incidence of complications [3].
  • Bipolar-cemented radial head implants show lower revision rates compared to other types [20].
  • Radial head replacement had better elbow function and fewer adverse events than open reduction and internal fixation (ORIF) for Mason type III radial head fractures in the short term [34].
  • Displaced unstable radial head fractures require restoration of radiocapitellar contact via reconstruction or prosthetic replacement to prevent elbow instability [19].
  • Radial head arthroplasty has a high potential for reoperation within the first year [25].
  • The highest annual failure rate for monopolar radial head replacement occurs in the first postoperative year [31].
  • Implant survival for monopolar radial head replacement is 75.1% at 18 years [31].
  • Survival rates for uncemented radial head implants remain high at 10 years [25].
  • Patients report excellent Quick Disability of the Arm, Shoulder, and Hand (DASH) scores at long-term follow-ups after radial head arthroplasty, despite any need for reoperation [25].
  • Midterm outcomes of EVOLVE radial head prostheses are satisfactory with low associated complication rates [32].
  • Long-term outcomes for radial head arthroplasty are satisfactory, though there is a high complication and revision rate [31].
  • If impingement symptoms of the radial head develop, secondary resection yields good results [28].
  • Twenty-one percent of pediatric radial neck fractures treated operatively heal with fair or poor outcomes [21].

Key Evidence

  • [L5] The challenge in the coming years will be to perform high-level clinical studies to obtain consensus regarding the most appropriate treatment for comminuted radial head fractures. [1] (10.1007/s00264-018-4082-9)
  • [L4] Radial head fractures are common and frequently accompanied by associated osseous injuries. [2] (10.1016/j.jse.2009.10.015)
  • [L4] Radial head implants offer a reliable treatment for complex Mason type III and IV fractures, with good functional and survival outcomes and a low incidence of complications. [3] (10.1016/j.jse.2025.05.038)
  • [L4] The complications of radial head fractures are characteristic to their classification. [4] (10.1016/j.jse.2018.11.047)
  • [L4] Associated injuries must be considered carefully when treating radial head fractures. [5] (10.1097/01.blo.0000180606.30981.78)
  • [L4] Injuries concomitant to radial head fractures were present in 11% of patients and the risk for these associated injuries increases with age. [6] (10.1186/s12891-015-0603-5)
  • [L3] It is important to determine which structures need to be repaired to avoid complications that could lead to elbow instability. [7] (10.1016/j.jse.2019.07.006)
  • [L4] Long-term patient-reported outcomes were excellent following the nonoperative management of isolated stable fractures of the radial head or neck. [8] (10.2106/jbjs.m.01354)
  • [L2] Subsequent radiographs during nonoperative treatment of isolated radial head or neck fractures were unhelpful and might contribute to overtreatment. [9] (10.1016/j.jse.2016.03.007)
  • [Paper] The absence of the cortical irregularity can be used to correctly identify a non-fractured radial head. [10] (10.1007/s00402-016-2496-7)
  • [L2] There is insufficient evidence to draw definitive conclusions on optimal treatment of type II-IV radial head fractures. [11] (10.1007/s00402-006-0240-4)
  • [L5] Clinical outcome studies of metallic radial head arthroplasty systems indicate that head replacement is a reasonable option to offer patients with comminuted radial head fractures and complex elbow trauma. [12] (10.1016/j.jhsa.2005.12.005)
  • [L4] Radial head and neck fractures have distinct epidemiological characteristics, and consideration for osteoporosis in a subset of patients is recommended. [13] (10.1016/j.jhsa.2011.09.034)
  • [L3] For radial head arthroplasties, acute trauma is the most common indication and Radial Head System the most commonly used implant. [14] (10.1177/1758573220987843)
  • [L4] The incidence of associated, osseous injuries of the upper limb in radial head fractures is high. [15] (10.1007/s11751-008-0038-8)
  • [L1] Based on the current evidence, conservative management of isolated Mason II radial head fractures yields favorable therapeutic outcomes with a low incidence of complications. [16] (10.1186/s13018-024-05039-6)
  • [L5] 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. [17] (10.5435/jaaos-22-10-633)
  • [L1] Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence. [18] (10.1016/j.injury.2013.04.003)
  • [L5] Most fractures of the radial head are stable and managed non-operatively with good long-term results, while displaced unstable fractures require restoration of radiocapitellar contact via reconstruction or prosthetic replacement to prevent elbow instability. [19] (10.1302/0301-620x.95b2.29877)
  • [L4] Radial head replacement is recommended for comminuted fractures with satisfactory medium- and long-term results, though bipolar-cemented implants show lower revision rates. [20] (10.1016/j.injury.2013.09.019)
  • [L4] Thirteen percent of patients with radial neck fractures require operative treatment, 21% of which heal with fair or poor outcomes. [21] (10.1097/bpo.0000000000000387)
  • [L3] This study confirms that radial head fractures in women aged 50 years are potentially osteoporotic fractures. [22] (10.1016/j.jse.2012.03.007)
  • [L4] ARIF is a safe and viable option for treating displaced radial head fractures. [23] (10.1016/j.xrrt.2024.08.001)
  • [L4] Because apparently isolated, stable partial fractures of the radial head are infrequently displaced and observers have moderate disagreement regarding the diagnosis of displacement, it is likely that displacement is overdiagnosed. [24] (10.1016/j.jse.2006.10.015)
  • [L4] Although radial head arthroplasty for fractures has a high potential for reoperation within the first year, survival rates with uncemented implants remain high at 10 years, and patients report excellent Quick Disability of the Arm, Shoulder, and Hand scores at long-term follow-ups, despite any need for reoperation. [25] (10.1016/j.jhsa.2023.04.020)
  • [L4] When a radial head fracture is present, the wrist should be carefully examined for a scaphoid fracture, and vice versa. [26] (10.1054/jhsb.2000.0495)
  • [L3] Ultrasound imaging proved to be an effective method for diagnosing occult fractures of the radial head or neck when initial radiograms showed only intraarticular effusion. [27] (10.1016/j.injury.2015.10.050)
  • [L3] If impingement symptoms of radial head develop, secondary resection yields good results. [28] (10.1016/j.jse.2011.02.002)
  • [L3] The results of this study suggest that in terrible triad injuries, the imaging appearance of radial head fractures has no measurable influence on treatment recommendations. [29] (10.5397/cise.2022.01368)
  • [L3] Treatment of radial head fractures may have an independent effect on outcome; the authors recommend reconstruction of comminuted radial head fractures in the context of a TTI, providing stable fixation can be achieved. [30] (10.1302/0301-620x.102b12.bjj-2020-2145)
  • [L3] Long-term outcomes for radial head arthroplasty are satisfactory; however, there is a high complication and revision rate, resulting in implant survival of 75.1% at 18 years with the highest annual failure rate observed in the first postoperative year. [31] (10.1016/j.jse.2020.11.031)
  • [L2] Midterm outcomes of EVOLVE radial head prosthesis are satisfactory, and associated complication rates are low. [32] (10.1177/1758573219850111)
  • [L4] The study also provided a treatment algorithm for radial head and neck fractures. [33] (10.1016/j.jseint.2024.09.031)
  • [L1] Compared with ORIF, there was some evidence that radial head replacement had better elbow function and fewer adverse events for Mason type III radial head fractures in the short term. [34] (10.1002/14651858.cd008987.pub2)
  • [L3] Overall reoperation rates are high in patients undergoing operative treatment of radial head and neck fractures. [35] (10.1177/1558944719837691)
  • [L3] Concomitant elbow fractures or dislocations do not affect the longer term outcomes of patients with unreconstructable radial head fractures requiring radial head arthroplasty. [36] (10.1016/j.jse.2017.06.031)
  • [L4] The management of acute unreconstructable fractures of the radial head in unstable elbow injuries with radial head replacement has a high risk of reoperation, with the peak risk appearing within 1 year after implantation. [37] (10.1097/corr.0000000000000876)
  • [L5] Most radial head fractures can be managed nonsurgically with early motion, while complex fractures associated with elbow instability require careful selection between open reduction and internal fixation and arthroplasty. [38] (10.5435/00124635-200707000-00003)
  • [L5] This study described the relationship between the coronoid and radial head, noting that the difference in radiographic height between the tip of the coronoid and anterior radial head in the normal elbow averages 5 mm. [39] (10.1016/j.jse.2021.05.025)
  • [L5] Nondisplaced and minimally displaced radial head fractures can be treated non-operatively with early mobilization. [41] (10.1530/eor-24-0035)
  • [L1] This study suggests that RHA is the best treatment of choice for efficacy and safety in the treatment of comminuted radial head fracture, while RHR is the safest choice to minimize postoperative complications and enable patients to perform all daily life activities. [42] (10.1007/s12306-020-00679-3)
  • [L4] The review aims to shed light into overlengthening as a complication of radial head replacement and to help identify and treat it. [47] (10.1007/s00402-020-03619-9)
  • [L5] The intraoperative decision to fix or replace the radial head is critical to optimize treatment outcomes. [49] (10.1016/j.hcl.2004.06.003)
  • [L4] The study shows a positive association between radiographic findings and patient symptoms for postoperative complications after radial head arthroplasty, validating radiography as the preferred postsurgical modality of imaging. [50] (10.2214/ajr.11.7674)
  • [L5] Radial head fractures should be viewed as osteoligamentous lesions rather than merely osseous lesions. [51] (10.1016/j.hcl.2015.06.003)
  • [L5] Radial head fractures are common with variable anatomy; treatment depends on fracture type and associated injuries, with conservative management for type 1, ORIF for type 2 with mechanical block, and arthroplasty or resection for type 3, particularly with ligamentous injury. [52] (10.1177/1758573219876921)
  • [L3] Anatomic radial head replacement has a risk of radiographic technical mistakes that correlate to poorer outcomes. [53] (10.1016/j.jseint.2026.101671)
  • [L4] ORIF and nonoperative treatment of isolated Mason type II radial head fractures provide comparably satisfactory functional outcomes, without significant differences. [54] (10.1016/j.jse.2020.10.011)
  • [L5] The ligaments have the most marked influence on stability, particularly when the upper limb is positioned such that valgus and varus gravity loads are applied to the elbow. [55] (10.1016/j.jse.2004.09.034)
  • [L5] The goals of current management are aimed at restoring normal anatomical and biomechanical function, with treatment dictated by fracture type, stability, and ligamentous integrity. [58] (10.1016/j.hcl.2007.01.009)
  • [L3] Our study demonstrates significant radiographic differences between two frequently used radial head arthroplasty implants. [60] (10.1097/bot.0000000000000876)

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