This narrative review synthesizes recent literature on three elbow implant categories: radial head, radiocapitellar (unicompartmental), and total elbow arthroplasty. It frames the indications, outcomes, and complications for each. The goal is to define which implant fits which patient and injury pattern.
The decision rule to carry into the trauma bay: never excise the radial head when the MCL, LCL, coronoid, or interosseous membrane is compromised. The radial head is the secondary valgus stabilizer and the key longitudinal forearm stabilizer, so its loss in an Essex-Lopresti or terrible-triad pattern produces instability you cannot easily fix later.
When sizing a radial head implant, err against overstuffing. Oversizing drives pain, stiffness, and capitellar erosion, and is the dominant reason these implants get revised. For the elderly patient with a comminuted, unfixable distal humerus fracture, linked TEA is a strong option. A mean MEPS near 92 and a 5% revision rate, plus Level-II RCT superiority over ORIF in patients over 65, support it.
The counterpoint is age. Failure clusters in patients under 60, so counsel young patients that lifelong lifting restrictions are the price of the implant.
This narrative review synthesizes recent literature on three elbow implant categories: radial head, radiocapitellar (unicompartmental), and total elbow arthroplasty. It frames the indications, outcomes, and complications for each. The goal is to define which implant fits which patient and injury pattern.
The decision rule to carry into the trauma bay: never excise the radial head when the MCL, LCL, coronoid, or interosseous membrane is compromised. The radial head is the secondary valgus stabilizer and the key longitudinal forearm stabilizer, so its loss in an Essex-Lopresti or terrible-triad pattern produces instability you cannot easily fix later.
When sizing a radial head implant, err against overstuffing. Oversizing drives pain, stiffness, and capitellar erosion, and is the dominant reason these implants get revised. For the elderly patient with a comminuted, unfixable distal humerus fracture, linked TEA is a strong option. A mean MEPS near 92 and a 5% revision rate, plus Level-II RCT superiority over ORIF in patients over 65, support it.
The counterpoint is age. Failure clusters in patients under 60, so counsel young patients that lifelong lifting restrictions are the price of the implant.