Radial head fractures are the most common fractures occurring around the elbow. Although
radial head fractures can occur in isolation, associated fractures and ligament injuries
are common. Assembling the clinical presentation, physical examination, and imaging
into an effective treatment plan can be challenging. The characteristics of the radial
head fracture influence the technique used to optimize the outcome. Fragment number,
displacement, impaction, and bone quality are considered when deciding between early
motion, fragment excision, and radial head excision, repair, or replacement. Isolated,
minimally displaced fractures without evidence of mechanical block can be treated
nonsurgically with early active range of motion (ROM). Partial, displaced radial head
fractures without evidence of mechanical block can be treated either nonsurgically
or with open reduction internal fixation (ORIF), as current evidence does not prove
superiority of either strategy. For displaced fractures with greater than 3 fragments,
radial head replacement is recommended. Radial head arthroplasty may be preferred
over tenuous fracture fixation in the setting of associated ligament injuries when
maintenance of joint stability could be compromised by ineffective fracture fixation.
Key word
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Article info
Publication history
Accepted:
December 29,
2008
Received:
November 28,
2008
Footnotes
G.J.W.K. receives royalties from Wright Medical Technology that are directed to a research account.
Identification
Copyright
© 2009 Published by Elsevier Inc.
