Radial Head Necrosis: Impacts of Surgical Removal

Radial head necrosis type 2

I apologize for the numerous questions.
Last time you mentioned whether to remove the radial head or the non-union area.
Will the removal have any impact on future outcomes?

Wǔshì, 40~49 year old female. Ask Date: 2016/02/25

Dr. Chen Yongxue reply Orthopedics

Whether to proceed with resection depends on whether the non-healing (or necrotic) radial head is affecting range of motion.
If resection is performed, the range of motion may improve, but strength during strenuous activities (such as push-ups) may be diminished.

Reply Date: 2016/02/25

More Info

Radial head necrosis, particularly following surgical removal, can have significant implications for a patient's long-term function and quality of life. The radial head is a critical component of the elbow joint, providing stability and facilitating movement. When it is removed due to necrosis or other conditions, several factors come into play that can affect the patient's recovery and future joint function.

Firstly, the removal of the radial head can lead to altered biomechanics of the elbow. The radial head plays a crucial role in the stability of the elbow joint, especially during rotational movements. Its absence can lead to increased stress on the remaining structures of the elbow, potentially resulting in pain, instability, and even the development of arthritis over time. Patients may experience limitations in their range of motion, particularly in pronation and supination (the rotational movements of the forearm).

Secondly, the surgical removal of the radial head can also impact the surrounding soft tissues, including ligaments and muscles. The altered mechanics can lead to compensatory movements that may strain these structures, resulting in pain and dysfunction. Rehabilitation following such a procedure is critical to restore function and minimize complications. Physical therapy focusing on strengthening the surrounding musculature and improving range of motion is often recommended.

In terms of long-term impacts, studies have shown that patients who undergo radial head excision may experience varying degrees of functional impairment. Some may adapt well and maintain a good range of motion, while others may develop chronic pain or instability. The degree of impact often depends on factors such as the extent of the necrosis, the presence of other joint injuries, and the individual's overall health and activity level.

Regarding the question of whether the radial head should be removed or if it can be preserved, this decision is typically made on a case-by-case basis. If the necrosis is extensive and the radial head is deemed non-viable, removal may be necessary. However, if there is a possibility of salvaging the radial head through other surgical interventions, such as debridement or fixation, those options may be explored to preserve joint function.

In conclusion, the surgical removal of the radial head due to necrosis can have significant implications for a patient's elbow function and overall quality of life. It is essential for patients to engage in a comprehensive rehabilitation program post-surgery and to have ongoing discussions with their healthcare providers regarding their recovery and any potential long-term impacts. Regular follow-ups and imaging may also be necessary to monitor the elbow joint's condition and to address any emerging issues promptly.

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