Surgical Discussion

This operation was done supine with the arm freely draped and positioned on a small table to the side. A lateral approach directly to the radio head through kaplans interval was used (well, formally you would say to kaplans interval represents probably just an EDC split). This approach provided direct access to the fracture using a relatively small surgical incision of around 5-6cm. The radial head fragment was retrieved but before reduction, absorbable k wires were used to stabilise the fractured but non displaced residual head fragment on the far ulnar side. The the head fragment was then anatomically reduced and fixed with two headless bone screws in a quasi tripod technique. Given the size of the fragment and the oblique nature of the neck extension an additional 1.7 mm Leibinger anti glide plate was implanted to prevent axial migration through wedge forces. 3 months post-op the patient describes a 95% recovery of elbow and arm function and has radiological bony union and unchanged osteosynthetic hardware. I even received a postcard explaining how happy the patient is to have retained her native radial head.