case_images: PMC11809273_01
case_images: Post-injury X-rays. The lateral and anteroposterior elbow views of the post-injury film are shown in the left and right panels, respectively. The yellow arrows demonstrate the impacted radial head fracture
case_images: cureus-0017-00000077276-i01.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i01.jpg
case_images: FIG1
case_images: Imaging showed a mildly displaced left radial head fracture, subluxation of the elbow joint, and a coronoid fracture (Figure 1).
case_images: Post-radial head arthroplasty X-rays. The lateral and anteroposterior views of the elbow after initial radial head arthroplasty are shown in the left and right panels, respectively. The yellow arrows demonstrate the radial head prosthesis implantation with adequate alignment
case_images: cureus-0017-00000077276-i02.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i02.jpg
case_images: FIG2
case_images: The patient was taken to the OR for his terrible triad injury and underwent left RHA, lateral ulnar collateral ligament (LUCL) repair, and open reduction and internal fixation (ORIF) of the coronoid (Figure 2).
case_images: Post-radial head cement spacer placement X-rays. The lateral and anteroposterior views of the elbow after the radial head cement spacer placement are shown in the left and right panels, respectively. The yellow arrows demonstrate an antibiotic radial head spacer molded over a 3.5 x 22 mm cortical screw, articulating with the lateral humeral condyle
case_images: cureus-0017-00000077276-i03.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i03.jpg
case_images: FIG3
case_images: The spacer was sized to match the diameter of the 24 mm implant but made 2-4 mm shorter as the spacer was a monoblock (Figure 3).
case_images: Final follow-up wrist X-rays. The anteroposterior and lateral views of the wrist at the final follow-up are shown in the left and right panels, respectively. On the anteroposterior view, the yellow arrow indicates that there is no widening at the distal radioulnar joint (DRUJ), with adequate alignment. On the lateral view, the yellow arrow indicates adequate alignment between the radius and ulna, without any radiographic signs of volar or dorsal ulnar subluxation
case_images: cureus-0017-00000077276-i04.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i04.jpg
case_images: FIG4
case_images: There was no DRUJ instability (Figure 4) or coronal instability at the elbow.
case_images: Final follow-up elbow X-rays. The lateral and AP anteroposterior views of the elbow at the final follow-up are shown in the left and right panels, respectively. The yellow arrows demonstrate joint space narrowing at the ulnar-trochlear joint
case_images: cureus-0017-00000077276-i05.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i05.jpg
case_images: FIG5
case_images: Radiographs obtained showed severe arthritic changes at the elbow (Figure 5).
case_images: Antibiotic-loaded cement radial head spacer. The left and middle panels show a radiographic image of the antibiotic cement spacer molded over a 3.5 x 22 mm cortical screw. The right panel shows a gross image of the antibiotic cement spacer, which was matched in size to the previously explanted radial head prosthesis
case_images: cureus-0017-00000077276-i06.jpg
case_images: PMC11809273_01_cureus-0017-00000077276-i06.jpg
case_images: FIG6
case_images: Using PALACOS MV+G cement (Heraeus Medical GmbH), which contains 0.5 g of gentamycin per 40 g bag, an additional 1 g of vancomycin is incorporated into the cement and a radial head spacer is constructed over a Synthes 3.5 x 22 mm cortical screw (Figure 6).