Fracture of the radial head and neck Discussion

Fractures of the radial head and neck may occur as isolated injuries, or may be part of a forearm or elbow fracture complex. These injuries have been classified by Mason and Johnson as follows:

I. Nondisplaced

II. Minimally displaced with depression, angulation and impaction

III. Comminuted and displaced

IV. Radial head fractures associated with dislocation of the elbow

Treatment options depend on the fracture type, and include immediate motion, open reduction, and radial head excision. Outcome following radial head or neck fracture may be graded according to the scheme of Radin and Riseborough:

Good: less than 10 degrees lost ROM in any direction, no symptoms

Fair: 10 - 30 degrees lost range of motion, minor complaints, or both

Poor: greater than 30 degrees lost motion, major complaints, or both

Late problems include loss of range of motion, pain, weak grip, degenerative joint changes, proximal migration of the radius with distal radioulnar joint problems, heterotopic ossification, cubitus valgus, cubital tunnel syndrome, as well as others. Prognosis is generally worse in older patients and those with more comminuted fractures. Discussion Home Page