Radial head preservation with internal fixation is the preferred treatment for displaced radial head and neck fractures. Although plate fixation has been used successfully, concerns remain about loss of forearm rotation. A technique of low-profile fixation using obliquely oriented screws from the radial head into the shaft has been developed to avoid distal dissection of the soft tissues and placement of hardware in an already-constrained area adjacent to the annular ligament and lateral ligamentous structures. This technique is most useful in axially stable fractures that have no or minimal shaft comminution and is our preferred method of treatment to avoid distal dissection and placement of hardware along the radial neck.
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Smith et al. (2007) studied this question.
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