This novel intramedullary nail repairs complicated radial head fractures using a design that eliminates the need for additional trauma plates, radial head resection or open reduction internal fixation that usually are required to fix complex radial head fractures. The design of the device also eliminates complications with current fixation systems, including joint stiffening that may lead to arthritis or soft tissue irritation that can lead to further complications.
Radial head and neck fractures are common orthopaedic injuries. While minimally displaced fractures can be treated without surgery, moderate and severe radial head fractures usually require surgical procedures like open reduction internal fixation, radial head resection or replacement arthroplasty, which use radial head plates to fix fractures. Current radial head plates have prominent hardware designs, which can cause soft tissue irritation and elbow stiffness after procedures, sometimes leading to arthritis. The use of plates may also result in additional surgeries to remove hardware and in increased occurrences of intrinsic elbow joint contracture.
Researchers at Wake Forest School of Medicine have developed an intramedullary nail for radial head and neck fracture fixation that converts the fractured radial head into an implant that works with the body’s healing process and does not need to be removed after healing is complete. The milling head of the intramedullary nail attaches to the inside of the fractured radial head and surgical screws are inserted to hold the fractured pieces together. The repaired radial head is inserted into the intramedullary canal and affixed with another surgical screw. This procedure is simpler than current radial head fixation techniques and does not require a surgical guide or radiology for installation.
The intramedullary nail is made of plastic instead of metal, allowing for ease of installation and the ability to fixate more complex fractures. The one-size-fits-all design of the nail provides for a strong biomechanical fixation and causes a near-zero hardware profile, which simplifies the procedure and restores elbow function without complications like soft tissue irritation, elbow stiffness or additional surgeries.
- One-size-fits-all design eliminates need for specialty plates
- Near-zero profile allows easy conversion to a radial head arthroplasty if required
- Eliminates prominent hardware and reduces soft tissue irritation
- Stronger fixation allows patients to start range of motion exercises earlier, with less pain and shorter recovery period
- Reduces arthritis associated with radial head resection by restoring normal elbow anatomy and motion
- Reduces health care costs by avoiding hardware removal and elbow contracture surgery
Zhongyu John Li, MD, PhD, Department of Orthopaedic Surgery
Radial head fractures, elbow trauma
Stage of Development
Proof of concept prototypes have been created and used in cadaveric studies.
Elbow trauma, radial head fractures, Mason type fractures, intramedullary nail, radial head plating system, radial shaft
John Druga, MS, MBA
Licensing Director, Center for Technology Innovation & Commercialization
Ref #: WFU 15-25