Temporary Cemented Spacer for Complex Radial Head Fractures: A Case Report.

BACKGROUND The management of comminuted and displaced radial head fractures (Mason III), particularly when associated with dislocation (Mason IV) or Essex-Lopresti injury, presents a complex surgical challenge. Treatment options include conservative management, surgical fixation, arthroplasty, or radial head resection; however, no consensus exists regarding the optimal approach for all injury types. Radial head resection is often preferred in complex cases with multiple fragments where reconstruction is unfeasible. While functional and radiological outcomes vary widely, there is a growing trend toward the use of prosthetic implants as the initial treatment to maintain elbow function and stability, with temporary implants employed when definitive ones are unavailable. CASE REPORT We present the case of a 46-year-old patient who underwent radial head resection and received a cemented radial head spacer as temporary management due to the unavailability of a definitive implant. Functional status was monitored over a 21-month period. Our aim was to identify a readily available operating room material capable of effectively neutralizing valgus and axial forces. Since the spacer is intended as a temporary solution, it must be removed or replaced with a definitive implant approximately 4-6 months postoperatively, once stability is reestablished. Beyond this period, bone lysis has been observed. CONCLUSIONS The significance of this case report lies in highlighting alternative options for radial head replacement in complex, irreparable fractures, proposing an easily accessible solution available in any orthopedic operating room. It is further distinguished by its extended follow-up period (21 months) and by providing evidence of the long-term tolerability of cemented spacers - an aspect that has been infrequently reported.