1、.1.2Preoperative AP radiograph of a Type 2 radial head fracture.3Preoperative lateral radiograph of a Type 2 radial head fracture.4Preoperative lateral radiograph of the Type 2 radial head fracture.5The elbow is flexed and positioned on a radiolucent table.The incision begins just above the lateral
2、epicondyle and extends down towards the ulna,passing directly over the radial head,as depicted.6The skin incision is brought down through the subcutaneoustissue and the common extensor origin is identified.7The common extensor origin is incised between the anconeus and the extensor carpi ulnaris ove
3、r the capitellum radial head.ANCONEUSANCONEUSECUECU.8The upper edge of the capitellum and the radial head are exposed.9RADIAL HEADRADIAL HEAD.10With sharp retraction and rotation of the radial head,the fracture is identified.Care must be taken not to extend this incision too far distally,as this may
4、 damage to the posterior interosseous nerve,as it lay over the radial neck.ANNULARANNULARLIGAMENTLIGAMENTRADIAL HEAD RADIAL HEAD FRACTUREFRACTURE.11A Freer elevator or small osteotome is introduced tomobilize the radial head fracture.12.13Close up viewCAPITELLUMCAPITELLUMRADIAL HEAD.14After anatomic
5、 reduction is achieved,K-wires are used to maintain the reduction.K-WIREK-WIREREDUCTIONREDUCTION.15After anatomic reduction is achieved,K-wires are used to maintain the reduction.K-WIREK-WIREREDUCTIONREDUCTION.16Using the external jig,a screw is placed such that it is countersunk below the articular
6、 surface of the radial head.In this example,a solid Herbert screw is utilized.17The reduced and fixed radial head.The Herbert screw seated under the articular surface.Occasionally,the second K-wire is exchanged for a Herbert screw.FRACTUREFRACTUREHERBERTHERBERTSCREWSCREW.18The range of motion of the
7、 forearm as well as pronation andsupination are confirmed,and the reduction is visualizedthroughout in arc of motion of the elbow.If adequately fixedand stable,closure is performed.FRACTUREFRACTUREHERBERTHERBERTSCREWSCREW.19The common extensor mechanism is brought together,enclosed over the radio-capitellar joint.20After closure.21Lateral view,demonstrating the reduction/10/29.22NoImage
