Radial head fractures: repair, excise, or replace?

The understanding of the role of the radial head with respect to elbow biomechanics continues to evolve. As newer concepts emerge, the approach to the operative treatment of radial head fractures is also changing. The treatment options remain the same: excision, open reduction with internal fixation, and arthroplasty. The indications for each surgical option are changing. With improved fixation devices and techniques, the role of open reduction and internal fixation is expanding. The improvements in techniques and materials make arthroplasty a more reproducible and successful procedure. As a result, indications for excision of the radial head, once the most common operative procedure for radial head fractures, are becoming more limited.