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Substituição da Cabeça Radial

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Um plano de recuperação protegido após a substituição da cabeça radial no cotovelo com um implante metálico, estruturado em torno de movimentos precoces e protegidos do cotovelo e do antebraço para prevenir rigidez, com o antebraço posicionado para proteger quaisquer ligamentos reparados e o cotovelo em repouso em uma simples atadura para conforto.

Ilustração de uma queda sobre a mão estendida, a maneira típica pela qual a cabeça do rádio se fratura.
A cabeça radial no cotovelo frequentemente se fragmenta em uma queda sobre a mão estendida; quando não pode ser reparada, é substituída por um implante metálico para manter a estabilidade e a mobilidade do cotovelo. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Este protocolo orienta a sua recuperação após a substituição da cabeça do rádio no cotovelo (onde uma cabeça do rádio fraturada é substituída por um pequeno implante metálico) com o Dr. Kieran Hirpara no Mater Private Hospital Rockhampton. Começa com o seu programa de exercícios em casa, seguido pelo protocolo clínico estruturado escrito para o seu terapeuta da mão; traga esta página ou o seu PDF para a sua primeira sessão de terapia para que a sua reabilitação permaneça coordenada. O seu terapeuta pode ajustar o plano dependendo de como a sua recuperação progride e do que exatamente foi reparado durante a sua operação.

Se tiver alguma preocupação sobre a sua ferida após a cirurgia, entre em contacto com a clínica. É frequentemente útil tirar uma foto da ferida e enviá-la por e-mail para avaliação.

O que esperar

A cabeça radial é a parte superior arredondada de um dos dois ossos do antebraço, onde se articula com o cotovelo. Quando está fragmentada em pedaços demais para ser reparada, é substituída por um implante metálico pequeno que restaura um cotovelo estável e congruente e um eixo de rotação do antebraço suave. Isso frequentemente é realizado como parte do reparo de uma lesão mais complexa, uma fratura-luxação às vezes chamada de "terceiro terrível", na qual a cabeça radial, uma parte do coronoide e os ligamentos laterais do cotovelo estão todos lesionados simultaneamente.

Como o implante restaura a estabilidade, a prioridade da sua reabilitação é o movimento precoce e protegido para prevenir rigidez; os cotovelos são muito propensos a ficar rígidos após esse tipo de lesão, e a melhor proteção contra isso é iniciar o movimento precocemente. Seu cotovelo é mantido em repouso em uma mouchara simples para conforto entre os exercícios (não uma órtese articulada), e a mouchara é removida para os exercícios e para a higiene.

Dois fatores determinam a rapidez e a amplitude do seu movimento:

  • Quaisquer ligamentos reparados precisam de proteção. Se o ligamento do lado externo do cotovelo (ligamento colateral lateral) foi reparado, o antebraço é mantido e exercitado com a palma voltada para baixo (pronação) nas fases iniciais; se o ligamento do lado interno (ligamento colateral medial) foi reparado, é mantido com a palma voltada para cima (supinação); se ambos, em uma posição neutra intermediária. Seu fisioterapeuta informará qual protocolo se aplica ao seu caso.
  • O cotovelo deve ser protegido contra estresse em varo (lateral) e, nas fases iniciais, contra a extensão completa se o cotovelo era instável. É por isso que o movimento é liberado em etapas, e não de uma só vez.

A amplitude de movimento é progressiva, com o fortalecimento geralmente iniciando por volta das seis semanas e o retorno às atividades completas por volta dos três meses. O implante e a cicatrização continuam se ajustando por vários meses, razão pela qual a carga mais pesada é reintroduzida gradualmente.

Precauções e limitações

  • Use a simples atadura para conforto, conforme orientado; não é uma órtese articulada, e deve ser removida para os exercícios e para a higiene.
  • Mantenha o antebraço na posição indicada pelo seu terapeuta durante os exercícios iniciais (palma para baixo se o ligamento lateral externo foi reparado, palma para cima se o ligamento medial foi reparado, neutro se ambos), o que protege o reparo.
  • NÃO aplique stress de valgo no cotovelo; evite apoiar-se no cotovelo ou deixar o braço pendurado sem suporte através do corpo nas fases iniciais.
  • NÃO force a extensão completa nas fases iniciais se lhe foi dito que o cotovelo era instável; estenda apenas dentro da amplitude permitida.
  • NÃO levante, empurre, puxe ou suporte peso através do braço operado até ser autorizado (comummente por volta das seis semanas); mantenha o uso da mão nas fases iniciais leve.
  • Mantenha o ombro, o pulso e os dedos em movimento desde o início, e NÃO conduza enquanto o braço estiver na atadura ou não conseguir controlar o volante com segurança.

Para a gestão da ferida, edema e cicatriz, consulte as orientações de cuidados da ferida da clínica.

Seus exercícios

Estes são os exercícios do seu material. Inicie-os apenas conforme orientado pelo Dr. Hirpara e pelo seu terapeuta da mão, mantendo-se dentro da amplitude e da posição do antebraço que lhe foram indicadas. Os exercícios iniciais mantêm o cotovelo e o antebraço em movimento para prevenir rigidez, sem sobrecarregar qualquer reparo: flexão e extensão do cotovelo assistidas pelo paciente, rotação suave do antebraço na direção permitida e manutenção da liberdade do ombro e da mão. O fortalecimento e o cuidado com a cicatriz pertencem a fases posteriores e não devem ser iniciados até que você receba liberação específica. Interrompa qualquer atividade que cause dor aguda ou a sensação de que o cotovelo está cedendo.

Seu protocolo clínico

O restante desta página é o protocolo clínico em fases para reabilitação após substituição da cabeça do rádio (artroplastia da cabeça do rádio), mais comumente realizada para uma fratura cominutiva da cabeça do rádio não reconstrutível, frequentemente como parte de uma fratura-subluxação do tríade terrível. Esta seção deve ser fornecida ao terapeuta da mão, e cada fase inicia-se com uma explicação em linguagem clara do que está ocorrendo. O implante restaura uma articulação radiocapitelar estável e congruente, portanto, o princípio orientador é o movimento precoce protegido para prevenir a rigidez a que estes cotovelos estão propensos, com o arco de movimento e a rotação do antebraço condicionados pela integridade de quaisquer reparos dos ligamentos colaterais e do coronoide.

Antes do tratamento, verifique o relatório cirúrgico do paciente e a avaliação de estabilidade sob anestesia, e entre em contato com o cirurgião assistente sobre: quais ligamentos colaterais e/ou coronoide foram reparados, o arco estável demonstrado intraoperatoriamente e a rotação protegida do antebraço. O Dr. Hirpara mantém o cotovelo em uma simples atadura para conforto (sem órtese articulada) e favorece uma abordagem de movimento precoce acelerado, onde a estabilidade permitir. Regra da posição do antebraço: reparo do LCL → exercício/repouso em pronação; reparo do MCL → supinação; ambos → posição neutra intermediária; evite estresse em varo e, onde o cotovelo era instável, a extensão terminal precoce.

Fase I — movimento protegido precoce (semanas 0 a 2)

As primeiras duas semanas iniciam com movimento protegido suave assim que a estabilidade da ferida o permitir (frequentemente dentro da primeira semana), para prevenir o desenvolvimento de rigidez. O braço repousa em uma simples atadura para conforto, sendo removida para os exercícios e higiene. O cotovelo percorre seu arco seguro com o antebraço mantido na rotação protetora para o ligamento que foi reparado.

Para o seu terapeuta da mão:

Educação e precauções - Imobilizar com uma simples atadura para conforto (sem órtese articulada); removê-la para exercícios e lavagem - Iniciar flexão-extensão ativa-assistida/ativa do cotovelo dentro do arco estável demonstrado intraoperatoriamente; evitar a extensão terminal se o cotovelo estava instável - Rotação do antebraço na posição protetora: pronação se o LCL foi reparado, supinação se o MCL foi reparado, posição neutra na faixa média se ambos foram reparados - Nenhum estresse em varo a qualquer momento; realizar exercícios acima da cabeça em decúbito dorsal quando instável para neutralizar o varo e usar a gravidade para coaptar a articulação - Não apoiar peso ou empurrar através do braço operado

Conduta - Ferida: curativos cirúrgicos conforme orientação; confirmar a estabilidade da ferida antes de iniciar o movimento - Edema: elevação, bombeamento suave da mão, gelo conforme necessário - Exercícios: AAROM/flexão-extensão ativa do cotovelo dentro do arco estável; pronação/supinação do antebraço na direção protegida com o cotovelo a 90°; amplitude de movimento (ROM) ativa completa do ombro, punho, mão e preensão

Critérios para progressão - Estabilização da ferida; movimento controlado e confortável dentro do arco protegido

Fase II — progressão do arco de movimento e rotação do antebraço (semanas 2 a 6)

Das duas às seis semanas, o arco de movimento protegido é gradualmente alargado em direção à extensão completa e a rotação do antebraço é liberada em ambas as direções, com o objetivo de alcançar pronação/supinação completa por volta das oito semanas. O fortalecimento e a carga continuam sendo evitados.

Para o seu terapeuta da mão:

Avaliações - Flexão-extensão do cotovelo ativa e passiva e rotação do antebraço; dor e inchaço; revisão da ferida/cicatriz; sintomas de instabilidade

Educação e precauções - Progressão em direção à extensão completa conforme a estabilidade permitir (liberar gradualmente qualquer bloqueio precoce de extensão) - Progressão da rotação do antebraço em ambas as direções em direção à amplitude total, mantendo cautela com o ligamento reparado no início desta fase - Continuar a evitar estresse em valgo e qualquer carga através do braço

Conduta - Exercícios: ampliar o arco de flexão-extensão do cotovelo até a amplitude total; progressão da pronação/supinação em direção à amplitude total (objetivo de amplitude total por volta das 8 semanas); iniciar o manejo da cicatriz assim que a ferida estiver cicatrizada; continuar com a amplitude de movimento do ombro/punho/mão - Um programa de mobilização em decúbito dorsal (supino) permanece útil onde há preocupação com instabilidade residual

Critérios para progressão - Amplitude de movimento completa e sem dor aproximando-se; sem sintomas de instabilidade; dor ≤3/10

Fase III — fortalecimento e retorno (semanas 6 a 12 e além)

Assim que a mobilidade for restaurada e os reparos forem considerados seguros (comumente por volta das seis semanas), inicia-se o fortalecimento, que é progressivo (começando pela pegada, seguido de trabalho de flexão/extensão do cotovelo e antebraço com resistência), avançando ao longo das semanas seguintes. O retorno a atividades mais intensas é baseado em critérios, tipicamente por volta dos três meses.

Para o seu terapeuta da mão:

Avaliações - Força do cotovelo e do antebraço em comparação com o lado contralateral; resposta à dor/inchaço ao carregamento; testes funcionais e específicos para trabalho/esporte, conforme apropriado

Educação e precauções - Iniciar fortalecimento com resistência suave (pegada → flexão/extensão do cotovelo com resistência e pronação/supinação) a partir de cerca de seis semanas; aumentar a carga gradualmente - Progressão para carregamento funcional e específico para o trabalho, conforme tolerado; evitar carregamento pesado súbito ou de impacto no início

Conduta - Exercícios: fortalecimento progressivo com resistência do cotovelo/antebraço (banda → pesos leves); fortalecimento da pegada; carregamento funcional graduado; continuar qualquer trabalho de mobilidade residual - Observar e relatar dor persistente ou piorante, sintomas mecânicos ou perda de mobilidade (possível sobrecarga/afrouxamento do implante ou desgaste capitelar), e encaminhar de volta ao médico assistente se a recuperação estagnar ou houver um resultado desfavorável - Considerar a alta quando a mobilidade for funcional e a força estiver quase simétrica

Critérios para retorno à atividade plena - Amplitude de movimento (ROM) funcional e sem dor; força quase simétrica; cotovelo confiante e estável sob carga

Retornar ao trabalho e às atividades

O uso leve das mãos nas atividades diárias (comer, escrever, cuidados pessoais leves) é incentivado desde o início, dentro dos limites do conforto, desde que não envolva empurrar, levantar ou apoiar peso através do cotovelo. Como não deve conduzir enquanto o braço estiver na tipóia ou incapaz de controlar o volante com segurança, planeie apoio para os transportes nas primeiras semanas; a condução retoma quando deixar de usar a tipóia e conseguir controlar o carro, conforme confirmado na sua consulta de acompanhamento.

O fortalecimento geralmente começa por volta das seis semanas e é progressivo. O retorno a trabalhos mais pesados, levantamento de cargas e desporto ocorre tipicamente por volta dos três meses, e baseia-se na recuperação do movimento completo, sem dor, e de força adequada e simétrica, com um cotovelo estável, sendo avaliado pelo Dr. Hirpara e pelo seu terapeuta da mão, e não apenas pelo calendário. O trabalho manual pesado e os desportos de contato seguem a mesma progressão baseada em critérios.

Após o seu protocolo

Este protocolo complementa as orientações gerais de recuperação da clínica; consulte o manejo da dor pós-operatória, o cuidado com a ferida e o manejo da cicatriz. O plano em fases acima reflete as orientações publicadas de reabilitação após artroplastia da cabeça do rádio e reconstrução do tríade terrível, e sua recuperação contínua é orientada individualmente pelo Dr. Hirpara e pelo seu terapeuta da mão, de acordo com a evolução do seu cotovelo e exatamente o que foi reparado.

Reviewed by Dr Kieran Hirpara · 21 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Radial Head Replacement — Procedure Outcomes & Post-operative Rehabilitation (Radial Head Arthroplasty for Unreconstructable Fracture / Terrible Triad)

Topic scope: post-operative rehabilitation after radial head arthroplasty (RHA) — replacement of an unreconstructable comminuted radial head with a metallic implant — performed either in isolation or, more commonly, as one component of reconstructing a fracture-dislocation (the "terrible triad": radial head + coronoid + lateral collateral ligament ± medial collateral ligament). The radial head is a key secondary stabiliser of the elbow against valgus and axial (posterolateral rotatory) load, so the implant exists to restore a stable, congruent radiocapitellar articulation and forearm axis — not merely to fill a defect.

Defining principle of the rehab here: the implant restores stability, so the dominant clinical enemy is stiffness, to which these elbows are strongly predisposed. The rehab is therefore an early protected-motion pathway — start moving within days to a week — explicitly gated by the integrity of the collateral-ligament and coronoid repairs done at the same operation. The two deliberate restraints are (1) the forearm rotation position that offloads the repaired ligament (pronation protects a repaired LCL; supination protects a repaired MCL; neutral mid-range when both), and (2) avoidance of varus stress and, where the elbow was unstable, early terminal extension. A simple sling is worn for comfort — not a hinged brace. The single biggest branch point is how much residual instability was demonstrated on examination under anaesthesia, which determines how fast the arc and forearm rotation are released.

A. PROCEDURE OUTCOMES (radial head arthroplasty; repair-vs-replace context)

Metallic RHA is a reliable reconstruction for the unreconstructable radial head, and — critically for rehab — it restores enough stability to permit early motion even in the setting of associated dislocation, provided the ligaments and coronoid are addressed.

  • RHA restores elbow stability and kinematics when the native head is unreconstructable, but ligament repair is required to fully restore stability. Cadaveric work shows radial head excision alters kinematics and stability, arthroplasty restores them in the ligament-intact elbow, and in the ligament-disrupted elbow arthroplasty plus LCL repair is needed to correct varus–valgus laxity [Beingessner et al., J Bone Joint Surg Am 2004, DOI 10.2106/00004623-200408000-00018]. Strong (mechanistic/biomechanical).
  • RHA gives functional, durable ROM in unstable elbow injuries equivalent to stable injuries. A 15-year single-surgeon series (68 patients) found patients with unstable radial head fractures plus dislocation achieved flexion and rotational arcs similar to stable injuries, with no difference in complication rate or implant survivorship — though supination loss was ~10° greater in the unstable group [Lott et al., J Shoulder Elbow Surg 2018, DOI 10.1016/j.jse.2017.10.011]. Moderate (Level II cohort).
  • Long-term monopolar implant survival is good, with stiffness/sizing the main failure modes. A 15-year follow-up of the Acumed anatomical (press-fit, monopolar) implant for Mason III–IV fractures confirms durable function and survival, with the principal complications being joint stiffness, malpositioning and improper sizing [Tarallo et al., J Shoulder Elbow Surg 2026, DOI 10.1016/j.jse.2025.05.038]. Moderate (long-term cohort).
  • Implant failure/revision risk is real, especially with associated instability. In a young active (military) cohort, RHA carried higher implant-failure rates than ORIF (20% vs 2.9%), and dislocation, coronoid fracture and concomitant ligament repair each predicted complications — underscoring that the injury complex, not just the implant, drives outcome [Kusnezov et al., HAND 2017, DOI 10.1177/1558944717715136]. Moderate.
  • Terrible-triad reconstruction aims explicitly to restore stability sufficient for early motion. Comprehensive reviews frame the entire surgical sequence (LCL repair, radial head fix/replace, ± coronoid, ± MCL/fixator) as a means to permit early ROM and pre-empt stiffness, posttraumatic arthrosis and instability [Fahs et al., J Am Acad Orthop Surg 2024, DOI 10.5435/jaaos-d-24-00310]. Moderate–strong (narrative review).

B. REHABILITATION / THERAPY EVIDENCE

The rehab evidence base is built on biomechanics + surgical-series protocols rather than RCTs: there is strong agreement on early protected motion and on forearm-position-based ligament protection, but the exact arc and timing are individualised to intra-operative stability.

  • Early motion is the consensus priority to prevent stiffness. Across operative series and textbook protocols, formal active and active-assisted ROM is begun within the first week once wound stability is confirmed, with splinting between sessions usually discontinued by 2–3 weeks and strengthening from ~6 weeks [Monica & Mudgal, Hand Clin 2010, DOI 10.1016/j.hcl.2010.04.008; Duckworth et al., Clin Orthop Relat Res 2014, DOI 10.1007/s11999-014-3516-y]. Moderate (consensus/series).
  • Motion is gated by stability, with varus stress avoided at all times. Where instability is a concern, an overhead (supine) rehabilitation protocol begun ~10–14 days post-op achieves early motion while gravity coapts the joint and neutralises varus; "a stiff stable elbow is preferred over a loose incongruous one" [Rockwood and Green's Fractures in Adults, 2019]. Moderate (textbook consensus).
  • Forearm rotation is positioned to protect the repaired ligament. Published RHA protocols position and exercise the forearm in pronation when the LCL was repaired, supination when the MCL was repaired, and neutral mid-range when both were repaired, progressing to full rotation as the repair consolidates [single-centre RHA protocol & narrative review, ResearchGate 2018; UVA / Christ Hospital RHA PT protocols — see URLs]. Weak–moderate (protocol consensus).
  • A coronoid fracture treated without fixation does not preclude early motion in selected triads. Where the LCL and radial head are addressed and intra-operative fluoroscopic stability is confirmed, type I–II coronoid fractures can be left unfixed and still rehabilitated with early motion to good ROM and DASH scores [Papatheodorou et al., Clin Orthop Relat Res 2014, DOI 10.1007/s11999-014-3471-7]. Moderate (Level IV series).
  • Restoring radiocapitellar contact (by replacement) is what permits the early-motion pathway in the unstable elbow; conservative or excision pathways are reserved for stable patterns and depend on the same early-mobilisation principle [Charalambous et al., J Shoulder Elbow Surg 2011, DOI 10.1016/j.jse.2011.02.013]. Moderate.

Recovery trajectory (expected, evidence-anchored)

Phase Window Restraint Therapy focus Strength / load Notes
I — Early protected motion Week 0–2 (often start <1 wk) Simple sling for comfort (no hinged brace); stable-arc only; forearm in ligament-protective rotation; no varus stress Active/active-assisted elbow flexion–extension within the intra-operative stable arc; forearm pro/sup in the protected direction; full shoulder/wrist/hand ROM; supine overhead programme if unstable None Wound stability confirmed before motion; "stiff-stable > loose-incongruous"
II — Arc & rotation progression Week 2–6 Release extension block / forearm rotation gradually as stability allows Progress elbow arc to full extension; open forearm rotation both directions; scar management once healed None Aim full pronation/supination by ~8 weeks; supination is the slowest to recover (~10° residual loss common)
III — Strengthening & return Week 6–12+ Restrictions lifted as repairs consolidate Grip → resisted elbow/forearm strengthening; graded functional and work-specific loading Begin ~6 wk, build gradually Return to heavier work/sport criterion-based ~3 months; watch for overstuffing/loosening/capitellar wear

(Phase windows mirror the precautions in the patient protocol; they are typical, stability-gated guides, not trial-derived deadlines.)

C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. Repair (ORIF) vs replace (RHA) the radial head. For reconstructable heads, ORIF is generally preferred and no prosthesis equals the native head biomechanically; for unreconstructable comminution (Mason III–IV) or in the unstable/dislocated elbow, RHA is the more reliable option because fixation constructs fail under the higher stresses [Kusnezov et al. 2017; Charalambous et al. 2011; Leigh & Ball, J Shoulder Elbow Surg 2012, DOI 10.1016/j.jse.2012.03.005]. Moderate; selection-dependent.
  2. Terrible-triad early motion vs protected immobilisation. Modern practice favours restoring enough stability (LCL ± radial head ± coronoid ± MCL/fixator) to permit early motion and avoid stiffness; the supine/overhead protocol exists precisely to reconcile early motion with residual instability. The trade-off ("stiff-stable preferred over loose-incongruous") is consensus, not RCT-settled [Rockwood and Green 2019; Fahs et al. 2024]. Moderate (consensus).
  3. Monopolar vs bipolar implants. Both are used; bipolar designs were intended to self-align and tolerate sizing imperfection, while monopolar anatomical implants show good long-term survival. No clear superiority is established, and overstuffing/sizing error harms either design more than the bearing type does [Tarallo et al. 2026; Doornberg et al., J Bone Joint Surg 2007, DOI 10.2106/jbjs.e.01340]. Weak (no head-to-head superiority).
  4. Implant-related complications. Overstuffing the radiocapitellar joint, malsizing and stem loosening cause capitellar erosion/osteopenia, pain and stiffness; capitellar erosion is reported from metal-on-cartilage articulation, and accurate head height/diameter is the key technical guard [Van Riet et al., J Bone Joint Surg 2004, DOI 10.2106/00004623-200405000-00028; Monica & Mudgal 2010]. Rehab cannot fix a malsized implant — persistent loading pain/stiffness warrants surgical review. Moderate.
  5. Supination is the laggard. Across series, forearm supination is the motion most likely to remain mildly deficient (≈10° loss), partly from scarring and partly from MCL-protective early positioning; patients should be counselled accordingly [Lott et al. 2018]. Moderate natural-history.

D. EVIDENCE STRENGTH FLAGS (summary)

  • STRONG (biomechanical / mechanistic): RHA restores elbow stability and kinematics only in concert with collateral-ligament repair (varus–valgus laxity corrected by RHA + LCL repair, not RHA alone).
  • MODERATE: functional ROM after RHA in unstable injuries equivalent to stable injuries with good implant survivorship (Level II–IV cohorts); long-term monopolar implant survival with stiffness/sizing as main failure modes; early-motion-to-prevent-stiffness as the governing rehab principle; supine/overhead protocol for the unstable elbow; supination as the slowest-recovering arc.
  • WEAK / CONSENSUS: the specific forearm-position-by-repaired-ligament rehab rule (pronation for LCL, supination for MCL, neutral for both) and the exact phase timings (protocol-derived, stability-gated, not RCT-validated); monopolar-vs-bipolar bearing choice (no proven superiority).

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • The Effect of Radial Head Excision and Arthroplasty on Elbow Kinematics and Stability. J Bone Joint Surg Am. 2004. DOI: 10.2106/00004623-200408000-00018
  • Radial Head Arthroplasty. Hand Clin. 2010. DOI: 10.1016/j.hcl.2010.04.008
  • Results after radial head arthroplasty in unstable fractures. J Shoulder Elbow Surg. 2018. DOI: 10.1016/j.jse.2017.10.011
  • Long-term survival of Acumed anatomical radial head implant for Mason type III-IV fractures: a 15-year follow-up. J Shoulder Elbow Surg. 2026. DOI: 10.1016/j.jse.2025.05.038
  • Operative Management of Unstable Radial Head Fractures in a Young Active Population. HAND. 2017. DOI: 10.1177/1558944717715136
  • Management of Elbow Terrible Triad Injuries: A Comprehensive Review and Update. J Am Acad Orthop Surg. 2024. DOI: 10.5435/jaaos-d-24-00310
  • Terrible Triad Injuries of the Elbow: Does the Coronoid Always Need to Be Fixed? Clin Orthop Relat Res. 2014. DOI: 10.1007/s11999-014-3471-7
  • Radial Head Replacement for Acute Complex Fractures: What Are the Rate and Risk Factors for Revision or Removal? Clin Orthop Relat Res. 2014. DOI: 10.1007/s11999-014-3516-y
  • Radial head reconstruction versus replacement in the treatment of terrible triad injuries of the elbow. J Shoulder Elbow Surg. 2012. DOI: 10.1016/j.jse.2012.03.005
  • Comminuted radial head fractures: aspects of current management. J Shoulder Elbow Surg. 2011. DOI: 10.1016/j.jse.2011.02.013
  • Radial Head Arthroplasty with a Modular Metal Spacer to Treat Acute Traumatic Elbow Instability. J Bone Joint Surg Am. 2007. DOI: 10.2106/jbjs.e.01340
  • Capitellar Erosion Caused by a Metal Radial Head Prosthesis. J Bone Joint Surg Am. 2004. DOI: 10.2106/00004623-200405000-00028
  • Comparative study of radial head resection and prosthetic replacement in surgical release of stiff elbows. Int Orthop. 2014. DOI: 10.1007/s00264-014-2594-5
  • Rockwood and Green's Fractures in Adults (terrible-triad surgical pitfalls; overhead/early-motion protocol; "stiff-stable preferred"). Wolters Kluwer, 2019.

Radial head replacement rehabilitation literature (URLs)

  • Rehabilitation protocol after radial head arthroplasty — a single-centre experience and narrative review of the literature. ResearchGate (2018). https://www.researchgate.net/publication/326168570
  • University of Virginia, Department of Orthopaedic Surgery — Radial Head Replacement Rehabilitation Guidelines (forearm-position-by-ligament; arc progression). https://med.virginia.edu/orthopaedic-surgery/wp-content/uploads/sites/242/2024/09/Radial-head-replacement.pdf
  • The Christ Hospital — Radial Head Replacement Physical Therapy Protocol (Rao). https://www.thechristhospital.com/landingpages/Documents/Rao%20PT%20Protocols/Operative/Elbow/Rao%20Radial%20Head%20Replacement%20r1.pdf
  • Cheshire Arm Clinic — Physiotherapy Protocol for Radial Head Replacement. https://cheshirearmclinic.co.uk/wp-content/uploads/2021/09/Radial-Head-Replacement.pdf
  • Denver Shoulder — Rehabilitation Protocol: Radial Head Replacement. https://www.denvershouldersurgeon.com/pdf/radial-head-replacement-protocol.pdf

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