Seventeen patients had a Silastic prosthesis for the radial head inserted following fracture of that structure. Follow-up averaged 6.7 years. Nine of the seventeen patients had had an associated dislocation of the elbow or a Monteggia fracture. Six patients received the implant at the time of the treatment for the fracture and all six were doing well, although the implant had failed radiographically in three of the six. There were five failures among the other eleven patients; four of the five had the prosthesis removed. On the basis of these data, we concluded that the indications for use of the Silastic radial-head prosthesis after fracture are extremely limited, and its routine use cannot be justified.