Posterolateral Approach to Radial Head

Lateral view of a right elbow through a Kocher type approach, opening the joint to show the radial head (R) and an osteochondral defect (ast
Lateral view of a right elbow through a Kocher type approach, opening the joint to show the radial head (R) and an osteochondral defect (asterisk). Image from Runer A, Berger MS, Sanchez Carbonel JF, Lacheta L, Mehl J, Siebenlist S. Radial Head Osteochondral Flake Refixation With a Transosseous All-Suture Technique. Arthrosc Tech. 2025, 14(5), 103374. CC BY 4.0.
Posterolateral Approach to Radial Head, radiograph of a radial head fracture
Radiograph of a radial head fracture. Image by James Heilman, MD, Wikimedia Commons, CC BY-SA 4.0.

Indications

  • ORIF
  • Excision
  • Replacement

Position

  • Supine
  • Arm positioned over chest
  • Pronate forearm

Landmarks

  • Lateral humeral epicondyle
  • Radial head
    • 2.5 cm distal to lateral epicondyle
  • Olecranon

Incision

  • 5 cm longitudinal incision
  • Start: Posterior surface of lateral humeral epicondyle
  • Continued downward & medially
  • End: towards the posterior border of ulna

Internervous Plane

Superficial Dissection

  • Deepen skin incision through fat & deep fascia
  • Identify the plane between anconeus & ECU
  • Develop it with blunt dissection & detach part of the superior origin of anconeus from the lateral humeral epicondyle

Deep Dissection

  • Fully Pronate forearm to protect the PIN
  • Incise capsule longitudinally
    • Capitellum
    • Radial head
    • Annular ligament
  • To expose capitellum
    • Cut down onto lateral supracondylar ridge
    • Elevate subperiosteally

Dangers

  • PIN 

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.