How to treat fractured elbow. Elbow Fracture ORIF: Comprehensive Guide to Treatment and Recovery

25.07.202302.07.2023 by alexxlab

What is elbow fracture open reduction and internal fixation. How is ORIF performed for elbow fractures. When is ORIF necessary for treating elbow fractures. What are the risks and complications of elbow fracture ORIF. How to prepare for elbow fracture ORIF surgery. What happens during and after elbow fracture ORIF procedure. How long does recovery take after elbow fracture ORIF.

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Understanding Elbow Fracture Open Reduction and Internal Fixation (ORIF)

Elbow fracture open reduction and internal fixation (ORIF) is a surgical procedure used to treat severe elbow fractures. This technique involves realigning the broken bone fragments and securing them in place using internal fixation devices like screws, plates, wires, or nails. ORIF is typically performed when conservative treatments are insufficient to properly heal the fracture.

The elbow joint consists of three bones: the humerus (upper arm bone) and the radius and ulna (forearm bones). Fractures can occur in any of these bones, often due to falls or direct trauma. When the bone fragments are significantly displaced or the fracture is complex, ORIF may be necessary to ensure proper healing and restore elbow function.

Key Components of Elbow Fracture ORIF

Open reduction: Surgically exposing the fracture site to realign bone fragments
Internal fixation: Using hardware to hold the bones in place during healing
General anesthesia: Typically used to ensure patient comfort during the procedure

When is Elbow Fracture ORIF Necessary?

While many elbow fractures can be treated with conservative methods like casting or splinting, certain situations require ORIF for optimal outcomes. Orthopedic surgeons may recommend this procedure in the following cases:

Significantly displaced bone fragments
Open fractures (bone piercing through the skin)
Comminuted fractures (bone broken into multiple pieces)
Fractures involving the joint surface
Unstable fractures that cannot be adequately immobilized with casting

Are there specific conditions that increase the risk of needing elbow fracture ORIF? Certain medical conditions, such as osteoporosis, can increase the likelihood of complex elbow fractures that may require surgical intervention. Additionally, high-energy injuries or falls from significant heights are more likely to result in fractures necessitating ORIF.

The Elbow Fracture ORIF Procedure: Step-by-Step

Understanding the ORIF procedure can help patients prepare mentally and physically for the surgery. Here’s a general overview of what to expect during an elbow fracture ORIF:

Anesthesia administration: General anesthesia is typically used to ensure the patient is unconscious and pain-free during the procedure.
Incision and exposure: The surgeon makes an incision over the fracture site to access the broken bones.
Fracture reduction: Bone fragments are carefully realigned to their proper anatomical position.
Internal fixation: The surgeon selects and applies appropriate fixation devices (e.g., plates, screws) to hold the bone fragments in place.
Wound closure: The incision is closed using sutures or staples, and a sterile dressing is applied.
Post-operative imaging: X-rays are taken to confirm proper alignment and fixation of the fracture.

How long does an elbow fracture ORIF procedure typically take? The duration of the surgery can vary depending on the complexity of the fracture, but it generally takes between 1 to 3 hours.

Risks and Potential Complications of Elbow Fracture ORIF

While elbow fracture ORIF is generally a safe and effective procedure, it’s important for patients to be aware of potential risks and complications. These may include:

Infection at the surgical site
Bleeding or hematoma formation
Nerve or blood vessel damage
Joint stiffness or reduced range of motion
Nonunion or malunion of the fracture
Hardware complications (e.g., loosening or breakage of screws or plates)
Allergic reactions to implant materials
Posttraumatic arthritis
Complications related to anesthesia

Can the risk of complications be minimized? While some risks are inherent to any surgical procedure, following your surgeon’s pre- and post-operative instructions carefully can help reduce the likelihood of complications. Factors such as maintaining a healthy lifestyle, quitting smoking, and managing underlying medical conditions can also contribute to better outcomes.

Preparing for Elbow Fracture ORIF Surgery

Proper preparation can help ensure a smooth surgical experience and optimize recovery. Here are some key steps to prepare for elbow fracture ORIF:

Provide a comprehensive medical history to your healthcare team
Undergo necessary preoperative tests and imaging studies
Disclose all medications, supplements, and allergies to your doctor
Follow instructions regarding fasting before surgery
Arrange for transportation and post-operative care
Prepare your home for recovery (e.g., setting up a comfortable resting area)

Should you stop taking certain medications before elbow fracture ORIF? Your surgeon may advise you to temporarily discontinue certain medications, such as blood thinners or anti-inflammatory drugs, to reduce the risk of bleeding during surgery. Always follow your doctor’s specific instructions regarding medication management.

Recovery and Rehabilitation After Elbow Fracture ORIF

Recovery following elbow fracture ORIF is a gradual process that requires patience and dedication. The timeline and specific rehabilitation protocol may vary depending on the nature of the fracture and individual factors. Here’s a general overview of the recovery process:

Immediate Post-operative Period (0-2 weeks)

Pain management with prescribed medications
Elevation of the arm to reduce swelling
Immobilization of the elbow with a splint or cast
Wound care and monitoring for signs of infection

Early Rehabilitation Phase (2-6 weeks)

Gradual introduction of gentle range of motion exercises
Transition from splint to removable brace
Continued pain management and swelling control
Follow-up appointments for wound check and X-rays

Progressive Rehabilitation Phase (6-12 weeks)

Increased focus on regaining full range of motion
Introduction of strengthening exercises
Gradual return to light daily activities
Continued physical therapy sessions

Advanced Rehabilitation and Return to Function (3-6 months)

Progressive strengthening and functional exercises
Sport-specific or occupation-specific training
Gradual return to more demanding activities
Final follow-up appointments and imaging studies

How long does it take to fully recover from elbow fracture ORIF? Full recovery can take anywhere from 3 to 6 months, depending on the severity of the fracture and individual healing factors. Some patients may continue to experience improvements in function for up to a year after surgery.

Long-term Outcomes and Considerations

The majority of patients who undergo elbow fracture ORIF experience significant improvements in pain and function. However, it’s important to have realistic expectations and understand potential long-term considerations:

Some patients may not regain full range of motion compared to their uninjured elbow
Mild residual stiffness or discomfort may persist, especially with extreme movements
There is a risk of post-traumatic arthritis developing in the future
Hardware removal may be necessary in some cases, typically after the fracture has fully healed
Regular follow-up with an orthopedic surgeon is important to monitor long-term outcomes

Can elbow function continue to improve beyond the initial recovery period? Many patients report ongoing improvements in strength and flexibility for several months to a year after surgery. Consistent participation in a home exercise program and maintaining an active lifestyle can contribute to optimizing long-term outcomes.

Preventing Elbow Fractures and Maintaining Bone Health

While not all elbow fractures can be prevented, there are steps you can take to reduce your risk and maintain overall bone health:

Practice fall prevention techniques, especially for older adults
Wear appropriate protective gear during sports and high-risk activities
Maintain a balanced diet rich in calcium and vitamin D
Engage in weight-bearing exercises to promote bone strength
Avoid smoking and excessive alcohol consumption
Undergo regular bone density screenings, particularly for those at risk of osteoporosis

How can you improve bone density to reduce fracture risk? Weight-bearing exercises, such as walking, jogging, or resistance training, can help stimulate bone formation and increase bone density. Additionally, ensuring adequate intake of calcium and vitamin D through diet or supplements can support optimal bone health.

Elbow fracture open reduction and internal fixation (ORIF) is a critical surgical intervention for severe elbow fractures. By understanding the procedure, its indications, and the recovery process, patients can better prepare for surgery and actively participate in their rehabilitation. While the journey to recovery may be challenging, the majority of patients experience significant improvements in elbow function and quality of life following ORIF. With proper care, dedication to rehabilitation, and ongoing maintenance of bone health, individuals can optimize their outcomes and reduce the risk of future fractures.

Elbow Fracture Open Reduction and Internal Fixation

What is elbow fracture open reduction and internal fixation?

Open reduction and internal fixation (ORIF) is a type of surgery used to
stabilize and heal a broken bone. You might need this procedure to treat
your broken elbow.

The elbow joint is a hinge type of joint composed of 3 bones. The humerus
(the upper arm bone) forms the joint with 2 bones of the forearm: the
radius and the ulna. The ulna forms the bony point of the elbow.

Different kinds of injury can damage any of the 3 bones that form the elbow
joint. This is especially common when you fall on an outstretched hand. The
bone may fracture into 2 or more pieces. In certain types of elbow
fractures, your bone has broken, but its pieces still line up correctly. In
other types of fractures (displaced fractures), the injury moves the bone
fragments out of alignment.

If you fracture your elbow, you might need ORIF to bring your bones back
into place and help them heal. During an open reduction,
orthopedic surgeons reposition your bone pieces during surgery, so they are
back in their proper alignment. In a closed reduction, a
doctor physically moves the bones back into place without surgically
exposing the bone.

Internal fixation
refers to the method of physically reconnecting the bones. This might
involve special screws, plates, wires, or nails that the surgeon places
inside the bones to fix them in the correct place. This prevents the bones
from healing abnormally. The entire operation usually takes place while you
are asleep under general anesthesia.

Why might I need an elbow fracture open reduction and internal fixation?

Certain medical conditions may make fracturing your elbow more likely. For
example, osteoporosis increases the risk of elbow fracture in many older
adults.

Not everyone with a fractured elbow needs open reduction and internal
fixation. In fact, most people don’t. If possible, your doctor will treat
your elbow fracture with more conservative treatments, like pain medicine,
splints, and slings.

You probably won’t need ORIF unless there is some reason your fracture
might not heal normally with these conservative treatments. You are likely
to need ORIF if:

The pieces of your broken bone are significantly out of alignment
Your broken bone pierced through your skin
Your bone broke into several pieces

In these cases, ORIF can place your bones back into their proper
configuration. This significantly increases the chance that your bone will
heal properly.

You might need ORIF for a fracture that occurs anywhere in your elbow
joint, including the lower part of your humerus and the upper parts of your
radius or ulna.

What are the risks for an elbow fracture open reduction and internal
fixation?

Most people do very well with ORIF for their elbow fracture. Although rare,
complications can occur. Possible complications include the following:

Infection
Bleeding
Nerve damage
Joint stiffness (common)
Joint instability
Bone misalignment
Complications from anesthesia
Broken screws or plates
Arthritis of the joint (months to years later)

There is also a risk that the fracture won’t heal properly, and you’ll need
a repeat surgery.

Your own risk of complications may vary according to your age, the anatomy
of your elbow fracture, and your other medical conditions. For example,
people with low bone mass or diabetes may be at greater risk of certain
complications. Smokers may also have an increased risk. Ask your doctor
about the risks that most apply to you.

How do I prepare for an elbow fracture open reduction and internal
fixation?

ORIF often takes place as an emergency or urgent procedure. Before your
procedure, a healthcare professional will take your medical history and do
a physical exam. You’ll need an image of your elbow, probably obtained with
an X-ray or magnetic resonance imaging (MRI). Tell your doctor about all
the medicines you take, including over-the-counter ones like aspirin. Also,
let your doctor know the last time you ate.

In some cases, your doctors might do your ORIF a little later. If so, talk
to your doctor about how to prepare for the procedure. Ask whether you
should stop taking any medicines ahead of time, such as blood thinners.
You’ll need to avoid food and drink after midnight the night before your
procedure.

What happens during an elbow fracture open reduction and internal fixation?

Your doctor can help explain the details of your particular surgery. The
details of your surgery will depend on the location and severity of your
injury. An orthopedic surgeon and a team of specialized healthcare
professionals will do the surgery. The whole operation may take a couple of
hours. In general, you can expect the following:

You will receive general anesthesia, so that you’ll sleep through the
operation and won’t feel any pain or discomfort during the procedure.
(Or, you may receive a local anesthesia and a medicine to help you
relax.)
A healthcare professional will carefully monitor your vital signs, like
your heart rate and blood pressure, during the operation. You may have
a breathing tube inserted down your throat during the operation to help
you breathe.
After cleaning the affected area, your surgeon will make an incision
through the skin and muscle of your elbow. (The specific site may vary
according to the bone injured.)
Your surgeon will bring the pieces of your fractured bone or bones back
into alignment (reduction).
Next, your surgeon will secure the pieces of the broken bone to each
other (fixation). To do this, he or she may use
screws, metal plates, wires, or pins. (Ask what the surgeon will use in
your case.)
Your doctor will make any other necessary repairs.
After the team has secured the bone, your surgeon will surgically close
the layers of skin and muscle around your elbow.

What happens after an elbow fracture open reduction and internal fixation?

Talk to your doctor about what you can expect after your surgery. You may
have some pain after your procedure, but pain medicine may help decrease
the pain. You should be able to resume a normal diet fairly quickly. You
will probably get an imaging test done, like an X-ray, to make sure the
surgery was successful. Depending on the extent of your injury and your
other medical conditions, you might be able to go home the same day.

For a while after your surgery, you’ll need to keep the arm immobile.
Often, this means you’ll need to wear a splint for several weeks. Make sure
to protect your splint from water. You’ll receive instructions about how
you can move your arm.

Your doctor might give you other instructions about caring for your arm,
like applying ice. Follow all your doctor’s instructions carefully. Your
doctor might not want you to take certain over-the-counter medicines for
pain, because some of these can interfere with bone healing. Your doctor
may advise you to eat a diet high in calcium and vitamin D as your bone
heals.

You might see some fluid draining from your incision. This is normal. Let
your doctor know right away if:

You see an increase in redness, swelling, or draining from your
incision
You have a high fever or chills
You have severe pain in your arm
You have a loss of feeling in the arm or hand

Make sure to keep all of your follow-up appointments. You may need to have
your stitches or staples removed a week or so after your surgery.

At some point, you may need physical therapy to restore strength and
flexibility to your muscles. Doing your exercises as prescribed can improve
your recovery. Most people are able to return to most of their normal
activities within a few months.

Next steps

Before you agree to the test or the procedure make sure you know:

The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications
are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or
problems
How much will you have to pay for the test or procedure

Treatment After an Elbow Fracture

The elbow can be vulnerable to injury. A fracture can result from a fall onto an outstretched arm, a twisting injury to the arm, or from direct trauma. An elbow fracture can cause severe pain and make movement extremely difficult. Treatment for an elbow fracture can vary and depends on the severity and exact location of the injury.

The Elbow Joint

The elbow is a complicated joint made up of three bones, the humerus (upper arm bone) and the ulna and radius (the bones in the forearm). The olecranon is part of the ulna and is the tip of the elbow, and the radial head is the end of the radius where it meets the elbow. The elbow is also made up of ligaments, muscles, and tendons, allowing the bones to move both forwards and backwards as well as rotate in a twisting motion.

Symptoms of A Fracture

The following symptoms can indicate a fracture:

Sudden, intense pain (especially with movement)
Swelling
Bruising
Stiffness
Limited range of movement (difficulty bending/straightening the elbow, inability to turn the forearm)
Tender to the touch
Visible deformity
Numbness/tingling/weakness in the arm, wrist, and hand
Joint instability

If you injure your elbow or experience any of these symptoms, you should seek prompt medical treatment from an orthopedist, as delaying treatment can lead to further damage.

Diagnosing A Fracture

Diagnostic imaging, such as an X-ray or CT scan, is required to confirm if a fracture is present and the exact location of it. It is also used to identify the severity of the damage, whether any bones are misaligned or displaced (when there is a gap between the bones), and to assess whether there are any bone fragments present.

There are different types of elbow fractures, which include:

Radial head and neck fractures (often occur as a result of a dislocated elbow, or falling on to an outstretched arm).
Olecranon fractures (from falling directly on the elbow).
Distal humerus fracture (more common in children and the elderly).

Treatment for Fractures

Treatment largely depends on the severity of the fracture and whether any of the bones have moved during the break, are misaligned, or have pierced the skin. The main goal of treatment is to align the fractured bones to allow new bone formation, correct healing, and to repair any other trauma.

Simple fractures are those that have not pierced the skin, are not misaligned, and are at low risk of moving out of place. They are typically treated with non-surgical methods. This includes immobilization, such as wearing a cast, splint, or sling until the bone heals, and rest, followed by a gentle and gradual increase in motion. Pain relief and anti-inflammatory medication may also help to alleviate symptoms.

For more serious and complex fractures, such as when the bone is out of place or unstable, surgery is often required to realign or stabilize the bones to ensure they heal correctly. Surgical hardware, including pins, metal plates, rods, and screws, may be required to hold the fractured bones together during the healing process.

Surgery may be necessary to remove any loose bone fragments and to repair any soft tissue damage. If any bones have been crushed or severely damaged, a bone graft may be required to fill in the gaps. If damage is severe, the surgeon may need to remove part of the bone, such as the radial head, and replace it with an artificial one to improve function and mobility.

After surgery, once bones have been properly aligned, a splint or cast will be applied. A splint may be used for the first few days to accommodate swelling, with a cast then applied when the swelling has reduced.

Rehabilitation

Even simple fractures can result in some loss of elbow extension. Elbow stiffness is also much more common in adult patients. Rehabilitation, including physical therapy and occupational therapy, is often recommended to help restore and maximize range of motion, reduce and avoid stiffness in the joint, and help you perform activities of daily living, such as getting dressed.

Rehabilitation is also recommended following fracture surgery to speed up recovery, increase strength and mobility, and reduce risk of future injuries. Physical therapy for an elbow fracture may include a number of modalities, including therapeutic exercises, manual therapies such as massage and joint mobilization, ice and heat therapies, ultrasound, and electrical stimulation.

Fracture Care in San Antonio, Texas

If you are experiencing elbow pain, speak to the experienced physicians at the Center for Orthopaedic Surgery and Sports Medicine. We provide prompt diagnosis and treatment for a variety of orthopedic conditions and injuries, including fractures, and are dedicated to providing you with the best patient-centered care available.

For more information or to schedule an appointment, call us at (210) 692-7400. Alternatively, you can fill out our online form.

Radial head fracture | orthoped-klinik.com

What causes a fracture of the head of the radius?
What symptoms are associated with a fracture of the head of the radius?
What complications can occur after a fracture of the radial head?
Treatment: how does the elbow specialist treat?

The complex elbow joint is formed by three bones: the humerus is connected to the ulna and radius of the forearm. All three elements are surrounded by a fibrous capsule. © Gelenk Clinic

A fracture of the head of the radius is an injury to the area near the elbow joint. This injury is one of the most common pathologies of the elbow joint in adults. The fracture occurs when the patient falls on an outstretched, slightly bent arm. Less often, a fracture of the radial head occurs during a direct fall or elbow strike.

Injuries to the head of the radius can result in:

simple
offset or
comminuted fractures
misalignment

In the case of complex fractures, the orthopedist must expect the occurrence of concomitant injuries of the joint capsule and ligaments, which in turn affects the further treatment and recovery time of the patient.

The usual symptoms of this pathology are pain in the elbow, as well as swelling on the outside of the elbow. In addition, the mobility of the elbow joint is limited.

The head of the radius is an important element of the elbow joint. Its rotation around its axis provides pronation and supination of the forearm.

In case of poor healing, the risk of arthrosis and prolonged pain

Before prescribing treatment, it is necessary to take into account the features of the fracture and associated damage to the ligamentous elements of the joint. Thus, our specialists will be able to prevent complications and negative consequences that may appear after unsuccessful healing. Incorrectly healed fractures can permanently limit the patient’s mobility and lead to instability of the elbow joint. Elbow stiffness, premature wear (arthrosis), or death (necrosis) are possible options for a malunion fracture.

Injuries of this nature should be treated in a specialized clinic by specialists in the treatment of diseases of the elbow joint. Only then will you be able to avoid serious consequences. Doctors of the orthopedic medical center Gelenk-Clinic will be happy to answer all your questions.

Causes of fracture of the radial head

A typical injury with a fracture of the head of the radius: a fall on an outstretched, slightly bent arm on the palm. © Halfpoint, Adobe Stock

Often this injury occurs during falls with an outstretched arm in a slightly bent position, if the victim tries to rest his palm on the floor. The forearm is slightly turned inward.

Thus, a sharp massive force is exerted on the elbow joint through the hand and outstretched arm. The head of the radius collides with the massive end of the shoulder, which leads to a fracture. In this case, the injury occurs through indirect force effects.

The more the elbow is stretched during a fall, the more likely it is to damage the head of the radius. Trauma can occur in any age group regardless of gender, although the average age of patients with this pathology is 40 years. People who are actively involved in sports suffer from this more often.

What are the symptoms of a fracture of the head of the radius?

Pressing pain in the injured area of the elbow
Pain on the outside of the elbow radiating to the hand
Redness, swelling and bruising
Limited mobility of the elbow joint, pain during rotation and extension of the forearm

Typical complaints with a fracture are pain and swelling on the outside of the elbow joint. Pronation and supination of the forearm is limited. As a rule, severe pain and the impossibility of full flexion and extension of the joint. © Sentello, Adobe Stock

Pressure on the damaged head of the radius causes severe local pain. Rotating movements of the forearm in and out, as well as flexion of the elbow, are possible only in the case of a willingness to endure pain. If swelling and bruising appear during a fracture, you may have injuries to the joint capsules and ligaments.

Often, such injuries are associated with hemorrhages in the joints, which further limits their mobility. Displaced fractures (dislocation) can completely stop the mobility of the elbow joint. As a result of a fall, other bone structures, such as the humerus and ulna, can also be damaged.

Nerve injuries are very rare – even in the most difficult cases. Damage to the radial nerve causes sensory disturbances in the arm. In addition, the original functions of the forearm may be impaired.

What injuries are associated with fractures of the head of the radius?

With fractures of the head of the radius, approximately every third patient notices additional damage to the ligamentous apparatus or bone structures.

Often the external ligament that strengthens the articular capsule of the elbow is damaged
Potential for injury to other lateral ligaments – annular ligament and joint capsule
The strong, connective tissue membrane that connects the ulna and radius can also be affected
Wrist bones can break on impact

Radial head fracture is not a purely bony injury. Very often, the patient also has ligament injuries, which must be paid attention to during the initial diagnosis and further therapy.

How can the head of the radius break?

Radial head fractures are classified according to Mason’s formula. There are four types of fractures. The classification takes into account the number of fragments, as well as the degree of their displacement (dislocation). Based on these criteria, doctors determine the degree of damage to the elbow joint.

Classification of fractures according to the Mason formula. Type 1: not displaced, no more than 2 mm displaced. Type 2: The bone fragment is displaced by more than 2 cm. Type 3: Comminuted. Type 4: Fracture and dislocation of the elbow. © Gelenk Clinic

What complications can occur after a fracture of the radial head?

Late or improper treatment of this pathology may lead to certain complications that will have a negative impact on the daily life and quality of life of the patient.

Complications after fracture of the radial head:

Limited mobility: this element of the elbow joint is important during the rotational movements of the forearm. Incorrectly fused fractures form steps in the joint, which makes perfect mobility impossible. Bone as well as cartilage fragments can get stuck in the joint space and thus completely block the internal and external rotation of the forearm.
Elbow Stiffness: The growths and scars from the healing process and the thickened joint capsule limit the function of the elbow joint. Longer immobilization of the elbow in flexion with a cast may limit the extension of the arm at the elbow.
Chronic instability of the elbow: If the ligaments and tendons do not heal properly, the joint becomes unstable. Chronic epicondylitis (tennis elbow) is sometimes caused by unstable ligaments from previous injuries.
Osteoarthritis of the elbow joint: Suboptimally fused fractures accelerate the process of cartilage wear in the elbow joint. Thus, premature wear begins, often several years after the injury.
Necrosis of the head of the radius due to circulatory disorders: especially after comminuted fractures, the blood vessels that feed the bone can be damaged. Often this can provoke death, i.e. necrosis of the head of the radius.
Injuries associated with unknown collateral injuries: The causes of trauma to the humerus and radius or fracture of the wrist sometimes remain undiagnosed.

Treatment: how does a specialist at the Gelenk Clinic in Germany treat a fracture?

Our many years of experience in the treatment of these pathologies allows us to carry out the therapy appropriate to the stage of the disease. At the same time, we necessarily take into account the individual requirements of the patient, as well as the nature of the underlying damage, including possible concomitant diseases and thus the expected prognosis of conservative and surgical treatment. Elbow specialists will provide you with an optimal consultation and develop an individual treatment plan.

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Surgical treatment

Multi-comminuted, displaced and malunion fractures require surgical intervention. The volume of surgical procedures depends on the degree of deformity. The orthopedic specialists at the Gelenk Klinik Gundelfingen can restore the original position of the joint during surgery.

1. Reconstruction with special screws and plates

Fractures with a displacement of more than 2mm (Type 2 according to the Mason formula) are usually treated with special screws and microplates. This intervention is called osteosynthesis and is minimally invasive.

The displaced bone fragment returns to its original position, where it is fixed. So the surgeon prevents the formation of steps on the articular surface. Used screws and plates do not need to be removed. They can be used to treat associated ligament injuries.

2. Reconstruction of the head of the radius with plates with angular stability

Treatment of a patient with a multi-comminuted fracture (Type 3) after a fall from a mountain bike: Combined osteosynthesis with angular stability plates. X-ray shows the state of the joint after healing. © Gelenk Clinic

Even complex fractures with several fragments and dislocations can be treated with osteosynthesis. To do this, the Gelenk Clinic uses special plates with angular stability, which securely fix individual fragments of the joint

3.

Irreparable fractures: placement of an endoprosthesis

Complications of the prosthesis of the radius, fixed from the outside: the radius with the prosthesis turned out to be longer than it was before. © Gelenk Clinic

In case of multicomminuted fractures of the head of the radius, its reconstruction is impossible. In this case, it is worth thinking about implanting a prosthesis.

From a medical point of view, this intervention is quite complex. The diameter of the prosthesis should match the original size of the head of the radius. Also, the prosthesis should not protrude noticeably in relation to the joint area. This phenomenon is called “Overstuffing” and should be avoided at all costs. Only in this way can the patient avoid pain, accompanied by limited mobility and increased wear of the articular cartilage in the elbow.

With a stable ligamentous apparatus on the inside of the joint, removal of the radial head can be performed without the need for a prosthesis. In this case, the body produces a cartilaginous scar replacement on the neck of the radius. This intervention is rather an exception.