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Radial Head Excision

Other popular names

None

Who does it affect?

People whom have sustained a previous injury to the radial head.

What is it?

The radial head of the elbow joint is removed.

When is a radial head excision used?

When someone experiences severe pain that does not settle with conservative measures. Sometimes the radial head is removed in patients with Rheumatoid arthritis.

Diagnosis

Bone damage is examined by x-ray.

Non-surgical treatment

Due to chronic damage, the use of plaster casts or other means will not help and surgery is the only available option.

Surgical treatment

Surgery is carried out under general anaesthetic and takes about 20-40 minutes. In many cases we also apply an arm block, which is an injection around the shoulder to temporarily prevent the nerves in the arm from carrying pain signals to the brain.  The aim of this bock is to lessen the post-operative pain in the elbow.  It will also have the effect of temporarily paralysing the arm on the day of the surgery.
An incision is made on the outer aspect of the elbow. It is approximately 5cm long. The radial head is removed and the wound is sutured closed. A bulky dressing is applied. 

Post-surgery rehabilitation

You can go home soon after the operation.  The anaesthetic will wear off after approximately 6 hours.  Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off.  The arm should be elevated as much as possible for the first 5 days to prevent the hand and fingers swelling. Gently bend and straighten the fingers and elbow from day 1. The dressing will be removed soon after your operation.  The wound is cleaned and redressed with a simple dressing.  Avoid forced gripping or lifting heavy objects for 2-3 weeks.  The sutures a trimmed 12 days after the operation. You should notice an improvement in symptoms within a few weeks but the final result may take some 3-6 months.

Return to normal routine

Keep the wound dry until the stitches are out at 12 days.

Return to driving:

The hand needs to have full control of the steering wheel and left hand the gear stick.  You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed.

Return to work:

Everyone has different work environments.  Returning to heavy manual labour should be prevented for approximately 4 - 6 weeks. Early return to heavy work may cause the tendons and nerve to scar into the released ligament.  You will be given advice on your own particular situation.

Risks

Overall over 95% are happy with the result. However complications can occur.

General risks (less than 1% each):

Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any elbow surgery from a minor procedure to a complex reconstruction).

Specific risks:

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