Radial Head Fracture

Scenario

28YO male who fell onto his right arm, presenting with elbow pain. The Following X-Ray has been performed.

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This is an AP and lateral plane film radiograph of an unknown skeletally mature patient’s Right Elbow. The most obvious abnormality is there is a displaced fracture of the radial head. The ulnohumeral joint is congruent. 

Mason classification

1

Un-displaced

2

Displaced amenable to fixation

3

Displaced not amenable to fixation

4

Radial head with dislocation of the elbow

                              

Take a history perform an examination.

Key examination: ROM – Check for mechanical block to elbow motion (aspiration of joint haematoma and injection of local anesthesia can aid in evaluation). Check stability of the elbow. Palpate wrist for tenderness (DRUJ). Interosseous membrane for tenderness, radius pull test (Essex-Lopresti)

Non operative

  • Sling/collar and cuff immobilisation for 2 days followed by active mobilisation
  • Useful for Mason 1 fractures

Operative

  • Plate or headless compression screws
  • Radial head replacement