![]() 280 degrees of the rim of the head articulates with the sigmoid notch and is covered by thick hyaline cartilage, whereas the non-articulating arc is covered by thinner cartilage. The radial side of the radiocapitellar joint is convex and covered by articular cartilage. Anatomical studies have demonstrated that the head is not circular and has variable offset. The radial head articulates with both the capitellum and proximal ulna. Two randomised controlled trials have shown improved clinical outcomes and lower complication rate following arthroplasty when compared to internal fixation. Modular design improves the surgeon’s ability to reconstruct the native joint. ![]() Overstuffing of the radiocapitellar joint is a frequent technical fault and has significant adverse effects on elbow biomechanics. Radial head arthroplasty aims to reconstruct the native head and is indicated when internal fixation is not feasible and in the presence of complex elbow injuries. ![]() Authors have reported that results from fixation are poorer and complication rates are higher if more than three fragments are present. Internal fixation should only be attempted when anatomic reduction and initiation of early motion can be achieved. Comparative studies have shown improved results from internal fixation over excision. Traditional radial head excision is associated with valgus instability and should be considered only for patients with low functional demands. Similarly the treatment of type III and IV fractures remain controversial. The degree of intra-articular displacement and angulation acceptable for non-operative management has yet to be conclusively defined. The management of Mason type II injuries is less clear with evidence supporting both non-operative treatment and internal fixation. Mason type I fractures are treated non-operatively with splinting and early mobilisation.
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