Surgical Discussion

Patient positioning:  Supine

Anatomical surgical approach:  Boyds

Single dorsal incision through Boyd's interval to access the radial head. Notably, there was no identifiable lateral collateral ligament (LCL) injury at the level of the capitellum. The neck fracture was complete, necessitating the removal of the radial head and the fragment, which were subsequently reconstructed on the back table using poly(L-lactic acid) (PLLA) pins. While the radial head was excised, transosseous suture refixation of the anterior capsule to the coronoid was accomplished, utilizing a technique that involved tying over an endobutton. Following the reconstruction, the radial head was reimplanted and secured using three HBS midi headless compression screws in a triplanar technique. The construct demonstrated stability throughout passive range of motion (ROM) assessment, with no signs of subluxation. Additionally, transosseous refixation of the lateral ulnar collateral ligament (LUCL) and the annular ligament was performed, followed by closure of Boyd's interval. Final fluoroscopic imaging during range of motion revealed stability in the joint.

Postoperative protocol:   Postoperatively, no immobilization was required. The patient was advised to commence early non-weightbearing range of motion exercises starting on day one following the procedure

Follow up:   Not specified

Orthopaedic implants used:   Not specified