| Classification |
Definition |
Clinical Characteristics |
Treatment |
| Type I |
Nondisplaced or mildly displaced
fractures of the radial head or neck |
No mechanical block but may
have decreased pronation and supination secondary to acute pain and/or
swelling |
Requires early mobilization
without cast treatment to avoid elbow and forearm contractures |
| Type II |
Displaced (>2 mm) fractures
of the head or neck (angulated) |
May have incongruity at the
fracture site and mechanical blockage to movement. Normally encompasses
more than a marginal lip of the radial head. Lack severe comminution. |
Usually require open reduction
and internal fixation (ORIF) but may benefit from excision in select circumstances
such as the elderly. If radial neck comminution is present, then consideration
of bone grafting is warranted. During the ORIF procedure, care needs to
be given to avoiding the posterior lateral corner to avoid posterior lateral
elbow instability. |
| Type III |
Severely comminuted fracture
of the radial head and neck |
Associated with adjacent injuries
such as TFCC tears, IOL tears of the forearm, or elbow dislocations (usually
posterior) with or without coronoid fractures. |
Need to be excised for restoration
of forearm movement. |
