Displaced radial head fractures are often associated with fracture dislocation of the elbow or forearm or injury to the medial collateral ligament of the elbow joint or the interosseous membrane of the forearm. Regardless of the type of fracture, the goal of treatment is to reestablish the stability of the forearm and elbow joint, restore the motor function of the forearm and elbow joint, and effectively maintain the length of the radius. In severely comminuted radial head fractures, there are differing opinions on whether to choose fracture reduction and internal fixation to re-establish continuity of the radial tuberosity or radial head replacement to restore continuity of the humeral-radial joint. The main complications of incisional internal fixation include osteonecrosis and radial head necrosis, etc. King believes that incisional internal fixation is preferred for severely comminuted radial head fractures if anatomic reduction and strong internal fixation can be obtained, and if this requirement is not achieved intraoperatively, radial head replacement is recommended. A good radial head prosthesis should match the normal anatomy. It should fit the articular surface of the humeral head during activity, the disc-like surface of the joint should hold the humeral head so as not to cause instability of the elbow joint, and the prosthesis should be inserted and removed without much difficulty. The bipolar prosthesis is widely used because the thickness of the radial head can be easily adjusted intraoperatively, avoiding postoperative elbow pain and limited movement due to excessive pressure on the humeral radial joint, and reducing the instability of elbow valgus caused by insufficient thickness of the prosthesis. Although experiments and practice have demonstrated that radial head prosthesis replacement can reconstruct the stability of elbow valgus, the trajectory of the humeral tuberosity, forearm rotation forward and backward activities, and elbow joint stability are still somewhat different from the normal situation. In conclusion, for severe comminuted radial tuberosity fractures, incision and internal fixation is preferred to restore its anatomy and to fix it strongly. When functional repositioning cannot be achieved intraoperatively in severe comminuted fractures, repair of the ulnar collateral ligament and prosthesis replacement are feasible. Metal and polyethylene prostheses are more commonly used, but cemented spacers are also a simple and economical remedy.