International Orthopaedics (SICOT) (2015) 39:1553–1561
DOI 10.1007/s00264-015-2773-z
ORIGINAL PAPER
Anthropometric study of the proximal radius: does radial head
implant fit in all cases?
Soo Hwan Kang 1 & Dong Yeop Kim 1 & Hyunwoo Park 1 & Hyun Seok Song 1
Received: 2 March 2015 / Accepted: 22 March 2015 / Published online: 10 May 2015
# SICOT aisbl 2015
Abstract
Purpose The purpose of this study was to evaluate anthro-
pometry of the radial head and neck and compare the results
with radial head prosthesis in current use.
Methods A total of 144 cases were analysed that underwent
antero-posterior (AP) elbow radiographs in full supination and
extension position between January 2013 and April 2013.
Mean age was 54.3 years (range, 21–79). The distance be-
tween the articular surface and the radial tuberosity, the height
of the radial head, the diameter of the radial head, and the
width of the proximal radioulnar joint were measured. The
specifications of 13 products from nine companies were com-
pared with the parameters.
Results The mean distance between the articular surface and
the radial tuberosity was 19.6 mm. Mean height, diameter, and
width of the proximal radioulnar joint were 10.6, 22.0, and
8.9 mm, respectively. A violation of the distal biceps insertion
will occur in up to 87.5 % of the cases when some of the
bipolar implants were used. The height of some of the implant
heads was larger than the height of head in our study. Al-
though the height and diameter of the radial head were similar
to those of previous reports, the distance between the articular
surface of the head and radial tuberosity was different.
Conclusion The anatomical parameters of the proximal radius
of the cases, especially the distance between the articular sur-
face of the head and the radial tuberosity, and the radial head
implant specifications should be assessed when selecting a
radial head implant.
* Hyun Seok Song
hssongmd@yahoo.com
1
Department of Orthopaedic Surgery, The Catholic University of
Korea, Seoul, South Korea
Keywords Proximal radius . Radial head . Radial head
replacement . Anthropometric study
Introduction
Radial head and neck fractures are common, accounting for
1.7–5.4 % of all adult fractures, and about one-third of all
elbow fractures [1]. Mason type III (comminuted) [1] or type
IV [2] radial head fractures are difficult to reduce anatomical-
ly. Thus, radial head excision or radial head replacement is
recommended for the cases difficult to reduce. Janssen and
Vegter reported excellent results of radial head excision in
17 of 21 patients (81 %) after 16–30 years of follow-up [3].
Antuna et al. [4] reported satisfactory results in more than
90 % of cases at a minimum of 15 years (mean, 25 years).
For the surgery of elbow stiffness, Yu et al. [5] showed no
significant difference with respect to the range of motion and
postoperative function between radial head resection and
prosthetic replacement. They suggested that radial head resec-
tion is preferable if the elbow is stable after complete
arthrolysis. However, some studies have reported unsatisfac-
tory results and complications such as valgus deformity, de-
creased range of motion, and pain in the distal radioulnar joint
after the radial head excision [6, 7]. The replacement is indi-
cated if complex radial head fractures are combined with any
ligamentous injuries. Katthagen et al. reported satisfactory
clinical results and low removal rate (3 %) in 29 cases of
non-reconstructable radial head fractures with instability [8].
After Speed reported a metallic cap for the radial head [9],
various types of prostheses have been developed and used.
Radial head prostheses consist of an intramedullary stem
and head component and are classified into monoblock and
modular designs. The monoblock design consists of a stem
and head as one piece, whereas the modular design is
1554 International Orthopaedics (SICOT) (2015) 39:1553–1561

assembled by placing the head on the stem according to the Table 1 Patient
demographics Factors Number
individual anatomy. Radial head prostheses can be divided
into unipolar and bipolar designs, according to movement Gender (male:female) 58:86
between the head and stem. Side (right:left) 80:64
Although many studies have reported good results follow- Age (decades)
ing radial head arthroplasty [10, 11], incorrect implant size can 20–29 years 7
cause complications. If a longer implant is used, the radius is 30–39 years 10
lengthened, which may result in complications such as de- 40–49 years 26
creased range of motion [12], erosion of the articular surface 50–59 years 49
of the capitellum [13] or early arthritis. In the biomechanical 60–69 years 33
study of uncemented stem design, an inadequately sized stem 70–79 years 19
increases the stem’s micromotion as well as the risk of pros-
thetic loosening [14].
An osteotomy beyond the fracture site is needed to insert Distance between the articular surface of the radial head
the stem when radial head arthroplasty is used. The amount and the radial tuberosity
(level) of cutting depends on the design of the implant. If
the osteotomy is performed proximally, the overall length A line connecting the proximal surface of the radial head was
of the radius increases. This lengthening produces drawn (Fig. 2). A second line that was parallel to the first line
overstuffing. In contrast, an osteotomy performed distally was drawn through the proximal border of the radial tuberos-
can violate the radial tuberosity, where the distal biceps ity. The distance between the two parallel lines was measured
tendon inserts. (A of Fig. 2).
The purpose of this study was to evaluate the anthropom- This distance was the maximum distal level of the
etry of the radial head and neck and compare the results with osteotomy while protecting insertion of the distal biceps. If
radial head prostheses in current use. Our hypothesis was that the length of the extra-medullary portion (head and collar) of
the implant would not fit in some cases. each product was larger than this parameter, the distal biceps
insertion would be violated, or the radio-capitellar joint would
be overstuffed. The neck cutting level was determined after
assembly and was changed based on the design and thickness
Materials and methods of the polyethylene in the head implant.

A total of 202 patients were included in the analysis, who

complained of elbow joint pain and underwent antero-
posterior (AP) elbow radiographs at our hospital between Jan-
uary 2013 and April 2013. Patients of age 20–79 years old
were enrolled. Fifty-eight cases were excluded because of 22
fractures, 14 with arthritis, and 22 improper AP radiographs.
The radiographs which were not taken in full supination and
extension position were determined to be improper AP radio-
graphs. Finally, 144 cases were analysed. Mean age was
54.3 years (range, 21–79), and there were 58 males and 86
females. The detailed demographic data are summarized in
Table 1.
All parameters were measured from AP radiographs with a
calibration bar (Fig. 1) using the PACS software (Marosis m-
view; Marotech, Seoul, Korea). This program automatically
measured the distance from the beam to the detector plate and
calculated the magnification on the PACS pictures. Prelimi-
narily, we validated the accuracy of the magnification in the
PACS using the calibration bar. Two orthopaedic surgeons
measured the radiographs separately, and the mean of the
two measurements was used for analysis. The inter-observer
reliability could be verified using an interclass correlation co-
efficient (ICC=0.96). Fig. 1 Calibration bar (arrows) attached to the lateral skin of the elbow
International Orthopaedics (SICOT) (2015) 39:1553–1561
Fig. 2 Measurements of the proximal radius on an antero-posterior
radiograph. Distance between the articular surface and radial tuberosity
(A); height of the radial head (B); diameter of the radial head (C); width of
the proximal radioulnar joint (D). Arrows indicates two round beads in a
calibration bar
Height of the radial head
The height of the radial head was measured on the medial side,
which was more rectangular in full supination position. A line
that was parallel to the line connecting the proximal surface of
the radial head was drawn at the metaphyseal flare of the radial
head. The distance between the two parallel lines was mea-
sured (B of Fig. 2).
Diameter of the radial head
The length at the widest level of the radial head was measured
(C of Fig. 2).
Width of the proximal radio-ulnar joint
The lesser sigmoid notch, the articular surface of the proximal
radio-ulnar joint, was identified at the lateral side of the prox-
imal ulna. Two lines vertical to the articular surface of the
proximal radio-ulnar joint were drawn at the proximal and
distal borders of the joint. The distance between the two lines
was measured (D of Fig. 2).
We searched for available radial head prosthesis products
on the Google website in August 2013 using the keywords
Bradial head arthroplasty, radial head replacement, radial
head prosthesis^. We analysed the types and specifications
of prostheses from the information at each company’s website
and from brochures. We excluded non-metallic implants (like
silicon). Thirteen products from nine companies were
searched. The specifications were compared with the above
parameters measured on radiographs.
1555
Statistical analysis
Differences in each of the parameters between males and
females were analysed using Student’s t-test for paramet-
ric variables and the Mann–Whitney U-test for non-
parametric variables. All statistical analyses were per-
formed using SAS version 9.1 software (SAS Institute,
Cary, NC, USA) and expressed with 95 % confidence
intervals.
This study protocol was approved by our Institutional Re-
view Board, which waived the requirement for informed con-
sent due to the minimal risk of simple radiograph and a routine
diagnostic procedure.
Results
Types of radial head prosthesis
Among 13 products from the nine companies, four products
were of the bipolar design, and nine were of the unipolar
design. In terms of assembly, ten were of the modular design
and three of the monoblock design.
The information and specifications of the implants are sum-
marized in Table 2. For example, the CRF II® (Tornier, Saint-
Ismier Cedex, France) was the first bipolar prosthesis, intro-
duced about 20 years ago. It provides two head diameters (19
and 22 mm) and two stem diameters. Head height was
14.7 mm. The length between the articular surface and the
collar of the assembled product was 22.5 mm. The RHS®
(Tornier) provided four head diameters (18, 20, 22, and
24 mm) and two stem types. Each stem provided a different
stem and neck length.
Distance between the articular surface of the radial head
and the radial tuberosity
The mean distance on the radiographs was 19.6±2.2 mm
(range, 13.2–25.4). A significant difference was observed be-
tween males and females (p=0.00) (Table 3 and Fig. 3).
The cutting level for the CRF II implant was 22.5 mm
distally. Only 12.5 % of our cases were greater than
22.5 mm, indicating that the distal biceps insertion would
be violated in 87.5 % of our cases when a CRF II implant
was used. This would occur in 40.3 % of the cases when
an RHS long stem was used. However, the cutting level of
the others was less than 15.5 mm (the smallest in our
study).
Height of the radial head
The mean height of the radial head was 10.6±1.1 mm
(range, 8.3–14.2). A significant difference was observed
1556 International Orthopaedics (SICOT) (2015) 39:1553–1561

Table 2 Dimensions and specifications of radial head prostheses

Prosthesis Typej Head diameter Head height Neck cutting level

CRF IIa B/M 19, 22 14.7 22.5

RHS®a B/M 18, 20, 22, 24 12 19, 22 (long stem) 13, 16 (short stem)
Katalyst™b B/M 18, 21, 24 6k >10k
rHead™ Reconc B/M 18 9.7k 11.3, 15.3
21 14.3, 18.3
24 17.3, 21.3
rHead™c U/M 18 9.3 12.3 15.3 11.3, 15.3
21 14.3, 18.3
24 17.3, 21.3
Ascension®d U/M 20 10.9, 16 12, 17.1 13, 18.1 10.9, 16 12, 17.1 13, 18.1
22
24
Anatomic radial head systeme U/M 20, 22, 24, 26,28 10 10, 12, 14, 16, 18
Radial headf U/M 18 9, 13 9, 13
21 11, 15 11, 15
25 12, 17 12, 17
Evolve®g U/M 18, 20, 22, 24, 26, 28 8.5–15 8.5–19
h
ExploR® U/M 20, 22, 24 10, 12, 14, 16, 18 10, 12, 14, 16, 18
Liverpool™ h U / MB 16 6–18 6–18
18 14–28 14–28
Swanson Titanium Radial Head g U / MB 19, 20, 21, 22, 23 10, 11, 11.5 12.5, 13.5 10, 11, 11.5, 12.5, 13.5
Solar radial headi U / MB Small medium 8, 11 9, 12, 15 8, 11 9, 12, 15
a
Tornier, Saint-Ismier Cedex, France
b
KMI, Carlsbad, CA, USA
c
SBI, Morrisville, PA, USA
d
Ascension Orthopedics, Austin, TX, USA
e
Acumed, Hillsboro, OR, USA
f
Corin Group PLC, Cirencester, UK
g
Wright Medical Technology, Arlington, TN, USA
h
Biomet, Warsaw, IN, USA
i
Stryker, Mahwah, NJ, USA
j
Type : B (bipolar) / U (unipolar) / M (modular) / MB (monoblock)
k
Calculated from specifications or photos, because not described

between males and females (p = 0.00) (Table 3 and
Fig. 4).
A larger head implant (than the anatomical head) was
inserted in all cases when CRF II was used. This would
occur in 90.3 % of the cases when the RHS implant was
used, and in 58.6 % of the cases when the Ascension®
(Ascension Orthopedics, Austin, TX, USA) implant was
used.
Diameter of the radial head
The mean diameter of the radial head was 22.0±2.1 mm
(range, 17.8–26.9). A significant difference was observed be-
tween males and females (p=0.00) (Table 3 and Fig. 5).
Most of the products supplied a small diameter head. When
three of the products (Ascension / Anatomical radial head
system; Acumed, Hillsboro, OR, USA / ExploR®; Biomet,

Table 3 Radiographic data

(average ± standard deviation, Parameters Total Male Female p-value
mm)
Radial head to radial tuberosity 19.6±2.2 21.3±1.9 18.5±1.7 0.00
Height of the radial head 10.6±1.1 11.4±1.0 10.0±0.9 0.00
Diameter of the radial head 22.0±2.1 24.0±1.4 20.6±1.2 0.00
Height of the proximal RU joint 8.9±1.2 9.7±1.1 8.4±0.9 0.00
International Orthopaedics (SICOT) (2015) 39:1553–1561 1557

Fig. 3 Distance between the

articular surface and the radial
tuberosity. Arrows represent the
smallest implant specification
covering a percentage of cases.
Letters represent the following
implants: A CRF II®, B RHS®, C
Katalyst™, D rHead™ Recon, E
rHead™, F Ascension®, G
Anatomic radial head system, H
Radial head, I Evolve®, J
ExploR®, K Liverpool™, L
Swanson Titanium Radial Head,
M Solar® radial head

Warsaw, IN, USA) were used, a larger head implant (than the
anatomical head) was inserted in 18.1 % of our cases.
Width of the proximal radio-ulnar joint
The mean width of the proximal radio-ulnar joint was 8.9±
1.2 mm (range, 5.9–12.5). A significant difference was
observed between males and females (p=0.00) (Table 3).
The mean difference between the head height and this param-
eter was 1.7 mm (range, 0.4–2.5; Fig. 6). Figure 6 shows a
normal distribution curve compared to the head height graph.
Direct comparisons between this parameter and the height
of the head implant were not logical. The contact surface of
the head implants could not be calculated.

Fig. 4 Height of the radial head.

Arrows represent the smallest
implant specification covering a
percentage of cases. Letters
represent the following implants:
A CRF II®, B RHS®, C
Katalyst™, D rHead™ Recon, E
rHead™, F Ascension®, G
Anatomic radial head system, H
Radial head, I Evolve®, J
ExploR®, K Liverpool™, L
Swanson Titanium Radial Head,
M Solar® radial head
1558 International Orthopaedics (SICOT) (2015) 39:1553–1561

Fig. 5 Diameter of the radial

head. Arrows represent the
smallest implant specification
covering a percentage of cases.
Letters represent the following
implants: A CRF II®, B RHS®, C
Katalyst™, D rHead™ Recon, E
rHead™, F Ascension®, G
Anatomic radial head system, H
Radial head, I Evolve®, J
ExploR®, K Liverpool™, L
Swanson Titanium Radial Head,
M Solar® radial head

Discussion Correct restoration of radius anatomy (length and diameter)

In this study, significant differences in the parameters were
observed between males and females. The distance between
the articular surface of the radial head and the radial tuberosity
is the maximum distal level for osteotomy. When some of the
bipolar implants were used, a violation of the distal biceps
insertion occurred in up to 87.5 % of the cases. The height
of some of the head implants was larger than needed in our
study. However, the diameters of most of the head implants
were smaller than those in this study.
is important during radial head replacement. However, few
anthropometric studies of radial head and neck dimensions
have been conducted [15–19]. Moreover, those studies were
performed using different methods (Table 4). Some studies
have been conducted on cadaveric bone [16, 17, 19], and
some using radiographic data [15, 17, 18]. Thus, there might
be disagreements among studies. We found no studies of
Asian populations.
Although head diameter and height were similar to previous
reports, the distance between the articular surface of the radial

Fig. 6 Width of the proximal

radio-ulnar joint
International Orthopaedics (SICOT) (2015) 39:1553–1561 1559

Table 4 Results of anthropometric studies of the proximal radius

Authors Method Number Age Country Head diameter Head diameter Head height Head to neck
(male/female) (years) (max, mm) (min, mm) (mm) length (mm)

Popovic et al. CT 51 (28/23) 35.3 Belgium 22.8±1.9 21.8±1.9 9.9±1.6 22.47±2.84

Beredjiklian et al. MRI 46 (31/15) 41 USA 23 22 12 25
Captier et al. Dry cadaver 96 ND France 21.7 20.2 15.3±2.3 ND
King et al. Fresh cadaver 28 73.2 Canada 24.3±2.4 22.6±2.4 ND ND
X-ray 40 54 Canada 24.3±2.8 ND ND ND
Swieszkowski et al. Fresh cadaver 17 (17/0) 50 Poland 23.36±1.14 22.26±1.18 10.14±1.38 ND
Our study X-ray 144 (58/86) 54.3 Korea 22.0±2.1 ND 10.6±1.1 19.6±2.2

ND not described

head and the radial tuberosity was measured in only two reports reported that a gap in the lateral ulnohumeral joint is a reliable
[15, 18], which were larger than the parameters in our study indicator of overstuffing. However, Rowland et al. [23]
(Table 4). This study suggested that the distance between the rejected the lateral ulnohumeral joint indicator because the
head and radial tuberosity was shorter than previous reports. lateral ulnohumeral joint space is often wider than the medial
The distance between the articular surface of the radial joint space and nonparallel in a normal elbow. Doomberg et al.
head and the radial tuberosity was the maximum osteotomy [24] suggested the lateral edge of the coronoid articular sur-
level without violating distal biceps insertion. In our study, face or the lesser sigmoid notch as an intraoperative indicator.
two of the bipolar implants violated distal biceps insertion Because the articular surface of the radial head is 0.9 mm more
when avoiding overstuffing. However, in two reports [15, proximal than the lateral edge of the coronoid process, placing
18], the mean parameter was larger than the neck cutting level the articular surface plane of the radial head even with or just
of two bipolar implants. Therefore, we suggest that the slightly more proximal than the lateral edge of the coronoid
osteotomy level in our cases would be problematic. Theoret- articular surface could be a useful guideline.
ically, the insertion of the distal biceps should be protected. Superiority between monopolar and bipolar radial head
However, an extent of the loss of tuberosity is not known to implants are controversial. Radial head anatomy is complex
induce the clinical problems. and varies among patients. Moreover, the articular surface of
The radial head articulates not only with the capitellum of the radial head is not circular. If a monopolar implant is not
the distal humerus but also the lesser sigmoid (radial) notch of
the proximal ulna. In our study, the width of the proximal
radio-ulnar joint was slightly shorter than the height of the
head. If the height of radial head prosthesis is larger than this
parameter, arthrosis of the proximal radio-ulnar joint would be
expected (Fig. 7). Three implants were thicker than the head
height parameter in more than 50 % of our cases.
If a large diameter implant is used, repair of the annular
ligament is difficult. Uneven contact on the capitellum would
result in arthrosis. However, only three implants were larger,
representing 18.1 % of our cases.
Lengthening of the radius leads to overstuffing of the
radiocapitellar joint. Van Glabbeek et al. found that
overlengthening the radius by 2.5 mm or more led to
overstuffing the radiohumeral joint and altered elbow kinemat-
ics [20]. Delelaux et al. suggested that capitellar erosion with a
radial head prosthesis is often related to malalignment and/or
hyperpression of the prosthetic head on the capitellum [21].
Several studies have reported methods to intraoperatively
detect overstuffing of the radiocapitellar joint. Frank et al. [22]
found that incongruity of the medial ulnohumeral joint be- Fig. 7 Radiograph of a 65-year-old female showing arthrosis (arrows) of
comes apparent radiographically only after overlengthening the proximal radioulnar joint after insertion of a larger head implant. The
is greater than 6 mm and it seems to be inappropriate. They distal biceps insertion was violated to avoid overstuffing
1560
inserted accurately, arthrosis and other problems occur. A bi-
polar prosthesis articulates between the head and stem, which
allows some angulation and improves adaptation to both the
lesser sigmoid notch and the capitellum if the anatomy is not
reconstructed properly. However, a bipolar prosthesis is less
stable than a monoblock design in cadaveric studies [25].
This study had several limitations. Because we measured
the parameters on plain radiographs, the measurements might
be different from the actual size of the radial head. However,
concern about the magnification could be managed by taking
the radiographs with the calibration bar in the same protocol
and overcome by the PACS software proved by the prelimi-
nary study (as described in the section of Materials and
Methods). Captier et al. [16] reported that 57 % of radial heads
are elliptical and 43 % are circular. King et al. [17] and
Popovic et al. [18] reported that the radial head is elliptical.
In this study, by measuring head diameters in full supination
and extension position, this could present the largest diameter
of the head. Actually, studies using a 3D-CT or cadavers could
suggest more information. However, this study has a clinical
usefulness because, in the clinical setting, a preoperative
templating usually is made using plain radiographs of the
contralateral elbow, not 3D-CT of the contralateral elbow.
We wanted to verify and apply to the preoperative templating
on a standard AP radiograph.
Radial head height and diameter were similar to those in
previous reports. The distance between the articular surface of
the head and the radial tuberosity were different. Furthermore,
we compared the parameters with the specifications of pros-
theses in current use. According to a comparison with pros-
thesis specifications, two of the bipolar implants violated dis-
tal biceps insertion when avoiding overstuffing. However, the
clinical results should be evaluated if the amount of the viola-
tion of tuberosity or overstuffing is answered to avoid prob-
lems. The anatomical parameters of the proximal radius of
each case and the radial head implant specifications should
be assessed when selecting a radial head implant.
Ethical approval All procedures performed in studies in-
volving human participants were in accordance with the eth-
ical standards of the institutional and/or national research
committee and with the 1964 Helsinki Declaration and its later
amendments or comparable ethical standards.
References
1. Mason ML (1954) Some observations on fractures of the head of the
radius with a review of one hundred cases. Br J Surg 42:123–132
2. Johnston GW (1962) A follow-up of one hundred cases of fracture
of the head of the radius with a review of the literature. Ulster Med J
31:51–56
International Orthopaedics (SICOT) (2015) 39:1553–1561
3. Janssen RP, Vegter J (1998) Resection of the radial head after
Mason type-III fractures of the elbow: follow-up at 16 to 30 years.
J Bone Joint Surg (Br) 80:231–233
4. Antuna SA, Sanchez-Marquez JM, Barco R (2010) Long-term re-
sults of radial head resection following isolated radial head fractures
in patients younger than forty years old. J Bone Joint Surg Am 92:
558–566. doi:10.2106/JBJS.I.00332
5. Yu SY, Yan HD, Ruan HJ, Wang W, Fan CY (2015) Comparative
study of radial head resection and prosthetic replacement in surgical
release of stiff elbows. Int Orthop 39:73–79. doi:10.1007/s00264-
014-2594-5
6. Mikic ZD, Vukadinovic SM (1983) Late results in fractures of the
radial head treated by excision. Clin Orthop Relat Res 181:220–228
7. Ikeda M, Oka Y (2000) Function after early radial head resection
for fracture: a retrospective evaluation of 15 patients followed for
3–18 years. Acta Orthop Scand 71:191–194. doi:10.1080/
000164700317413184
8. Katthagen JC, Jensen G, Lill H, Voigt C (2013) Monobloc radial
head prostheses in complex elbow injuries: results after primary and
secondary implantation. Int Orthop 37:631–639. doi:10.1007/
s00264-012-1747-7
9. Speed K (1941) Ferrule caps for the head of the radius. Surg
Gynecol Obstet 73:845–850
10. El Sallakh S (2013) Radial head replacement for radial head frac-
tures. J Orthop Trauma 27:e137–e140. doi:10.1097/BOT.
0b013e318269b7b7
11. Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ
(2006) Comminuted radial head fractures treated with a modular
metallic radial head arthroplasty. Study of outcomes. J Bone Joint
Surg Am 88:2192–2200. doi:10.2106/JBJS.E.00962
12. Birkedal JP, Deal DN, Ruch DS (2004) Loss of flexion after radial
head replacement. J Shoulder Elbow Surg 13:208–213. doi:10.
1016/S1058274603002854
13. Van Riet RP, Van Glabbeek F, Verborgt O, Gielen J (2004)
Capitellar erosion caused by a metal radial head prosthesis. A case
report. J Bone Joint Surg Am 86:1061–1064
14. Shukla D, Fitzsimmons J, An KN, O'Driscoll S (2014) Prosthetic
radial head stem pull-out as a mode of failure: a biomechanical
study. Int Orthop 38:89–93. doi:10.1007/s00264-013-2074-3
15. Beredjiklian PK, Nalbantoglu U, Potter HG, Hotchkiss RN
(1999) Prosthetic radial head components and proximal radi-
al morphology: a mismatch. J Shoulder Elbow Surg 8:471–
475
16. Captier G, Canovas F, Mercier N, Thomas E, Bonnel F (2002)
Biometry of the radial head: biomechanical implications in prona-
tion and supination. Surg Radiol Anat 24:295–301. doi:10.1007/
s00276-002-0059-9
17. King GJ, Zarzour ZD, Patterson SD, Johnson JA (2001) An anthro-
pometric study of the radial head: implications in the design of a
prosthesis. J Arthroplasty 16:112–116. doi:10.1054/arth.2001.
16499
18. Popovic N, Djekic J, Lemaire R, Gillet P (2005) A comparative
study between proximal radial morphology and the floating radial
head prosthesis. J Shoulder Elbow Surg 14:433–440. doi:10.1016/j.
jse.2004.10.012
19. Swieszkowski W, Skalski K, Pomianowski S, Kedzior K (2001)
The anatomic features of the radial head and their implication for
prosthesis design. Clin Biomech 16:880–887
20. Van Glabbeek F, van Riet RP, Baumfeld JA, Neale PG, O'Driscoll
SW, Morrey BF, An KN (2005) The kinematic importance of radial
neck length in radial head replacement. Med Eng Phys 27:336–342.
doi:10.1016/j.medengphy.2004.04.011
21. Delclaux S, Lebon J, Faraud A, Toulemonde J, Bonnevialle N,
Coulet B, Mansat P (2015) Complications of radial head prostheses.
Int Orthop. doi:10.1007/s00264-015-2689-7
International Orthopaedics (SICOT) (2015) 39:1553–1561
22. Frank SG, Grewal R, Johnson J, Faber KJ, King GJ, Athwal GS
(2009) Determination of correct implant size in radial head
arthroplasty to avoid overlengthening. J Bone Joint Surg Am 91:
1738–1746. doi:10.2106/JBJS.H.01161
23. Rowland AS, Athwal GS, MacDermid JC, King GJ (2007) Lateral
ulnohumeral joint space widening is not diagnostic of radial head
arthroplasty overstuffing. J Hand Surg [Am] 32:637–641. doi:10.
1016/j.jhsa.2007.02.024
1561
24. Doornberg JN, Linzel DS, Zurakowski D, Ring D (2006) Reference
points for radial head prosthesis size. J Hand Surg [Am] 31:53–57.
doi:10.1016/j.jhsa.2005.06.012
25. Moon JG, Berglund LJ, Zachary D, An KN, O'Driscoll SW (2009)
Radiocapitellar joint stability with bipolar versus monopolar radial
head prostheses. J Shoulder Elbow Surg 18:779–784. doi:10.1016/
j.jse.2009.02.011