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Preoperative AP radiograph of a Type 2 radial head fracture.1Preoperative AP radiograph of Preoperative lateral radiograph of a Type 2 radial head fracture.2Preoperative lateral radiograpPreoperative lateral radiograph of the Type 2 radial head fracture.3Preoperative lateral radiograpThe elbow is flexed and positioned on a radiolucent table.The incision begins just above the lateral epicondyle and extends down towards the ulna,passing directly over the radial head,as depicted.4The elbow is flexed and positiThe skin incision is brought down through the subcutaneoustissue and the common extensor origin is identified.5The skin incision is brought dThe common extensor origin is incised between the anconeus and the extensor carpi ulnaris over the capitellum radial head.ANCONEUSECU6The common extensor origin is The upper edge of the capitellum and the radial head are exposed.7The upper edge of the capitelRADIAL HEAD8RADIAL HEAD8With 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 damage to the posterior interosseous nerve,as it lay over the radial neck.ANNULARLIGAMENTRADIAL HEAD FRACTURE9With sharp retraction and rotaA Freer elevator or small osteotome is introduced tomobilize the radial head fracture.10A Freer elevator or small oste1111Close up viewCAPITELLUMRADIAL HEAD12Close up viewCAPITELLUMRADIAL After anatomic reduction is achieved,K-wires are used to maintain the reduction.K-WIREREDUCTION13After anatomic reduction is acAfter anatomic reduction is achieved,K-wires are used to maintain the reduction.K-WIREREDUCTION14After anatomic reduction is acUsing the external jig,a screw is placed such that it is countersunk below the articular surface of the radial head.In this example,a solid Herbert screw is utilized.15Using the external jig,a screThe reduced and fixed radial head.The Herbert screw seated under the articular surface.Occasionally,the second K-wire is exchanged for a Herbert screw.FRACTUREHERBERTSCREW16The reduced and fixed radial hThe range of motion of the 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.FRACTUREHERBERTSCREW17The range of motion of the forThe common extensor mechanism is brought together,enclosed over the radio-capitellar joint.18The common extensor mechanism After closure.19After closure.19Lateral view,demonstrating the reduction20Lateral view,demonstrating th
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