PMC5420185_01
(Technical Note LRETM system): (a) Photograph demonstrating the metal-on-UHMW PE articulation. (b) PA an lateral fluoroscopy intraoperatively showing correct insertion of radial and capitellar components in direction of their axes, and intraoperative clinical photograph showing the cortical frame around the offset of radial UHMW PE component (arrows).
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Hence, the uncemented radiocapitellar replacement using both components of the LRETM system was performed (Fig. 1b).
(Case Presentation): (a) Lateral radiograph and 3D CT scan demonstrating CSF type IV with anterior displacement of trochlea as well as capitellum of 30  (lines, points), note the pathognomonic "double arc sign" (arrows). (b) PA radiograph after primary ORIF showing correct alignment of the distal part of humerus without step-off in both articular surfaces.
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The lateral radiograph showed anterior displacement of the trochlea as well as the capitellum of 30  to normal that was associated with the "double arc sign" (Fig. 2a). The trochlea as well the capitellum were anatomically reducted using seven 2,4 mm headless compression screws in antegrade as well as retrograde manner, and the osteotomy of the lateral column of distal part of humerus was anatomically reducted using three 3,5 mm cortical compression screws (Fig. 2b).
(Case Presentation): (a) Lateral radiograph three years after ORIF showing migration of one of the headless compression screws into radiocapitellar joint (arrow) despite complete union of CSF. (b) Lateral radiograph after removal of all three headless compression screws of capitellum showing no signs of posttraumatic/postoperative OA.
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The lateral radiograph showed intraarticular migration of one headless compression screw despite complete union of CSF (Fig. 3a). All three screws primarily inserted into capitellum were removed (Fig. 3b), and the patient was pain free for another year.
(Case Presentation): (a) PA radiograph and intraoperative clinical photograph four years after ORIF including one year after partial removal of headless compression screws showing distinctive OA of the capitellum (yellow arrows) without any signs of degenerative changes of radial head radiographically, but intraoperatively there was pronounced deep circular cartilage defect (white arrows). (b) PA and lateral radiographs showing correct positioning and alignment of LRE  system without any signs of overstuffing.
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The posteroanterior (PA) radiograph showed distinctive posttraumatic OA of the capitellum without any signs of degenerative changes of radial head (Fig. 4a). In contrast to the radiograph, intraoperatively there was additionally a deep circular cartilage defect of radial head due to the formerly backing out of a headless compression screw (Fig. 4a). Postoperative radiographs showed correct alignment of implant without any signs of overstuffing (Fig. 4b).
(Case Presentation): (a) Clinical photograph and lateral radiograph demonstrating elbow flexion of 150  of both arms, and there is no impingement between both prosthetic components with terminal range of motion. (b) Clinical photograph and lateral radiograph of elbow extension demonstrating a deficit of 15  to contralateral, and there is no impingement between both prosthetic components with terminal range of motion. (c) Clinical photographs showing each 90  supination and pronation of both forearms.
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Elbow flexion was with 150  equal to contralateral, and the lateral radiograph with terminal range of motion revealed no impingement between both prosthetic components (Fig. 5a). Elbow extension showed unchanged a deficit of 15  compared to the unaffected right elbow, and the lateral radiograph with terminal range of motion revealed no impingement between both prosthetic components as well (Fig. 5b) Supination with 90  and pronation with 90  showed no functional deficits compared to the unaffected right forearm (Fig. 5c).