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Background: Radial head arthroplasty is commonly used to treat acute unreconstructible radial head fractures. The purpose of this study was to report on the clinical and radiographic outcomes after radial head arthroplasty with a metallic implant for the treatment of acute radial head fractures. Materials and Methods: Seven patients with unconstructable communited acute radial head fractures were treated with radial head replacement. Patients were selected according to the indication and rejected or delayed according to contraindication. Necessary written informed consent was taken. Observation and Results: All patients had good alignment and the full range of the function of the elbow without any major complications. Radiological alignment was also comparable with the other side. Follow-up noted up to 6 months only. Conclusions: Radial head replacement can be a good alternative for the treatment of communited radial head fractures which cannot be fixed. Although longer follow-up is needed.