Figure 4b. Anteroposterior (a) and lateral (b) radiographs of the left elbow show a cemented semiconstrained total elbow arthroplasty prosthesis (Discovery elbow; Biomet). A bone graft (arrow in b) taken from the resected trochlea is usually placed between the humeral shaft and the flange to enhance fixation and the stability of the implant. A cerclage wire is also placed about the fractured proximal ulna. The proximal portion of the radial intramedullary rod is seen on the anteroposterior view.