Radial Head Fractures Flashcards
What is the epidemiology of radial head fractures
Most common elbow fracture
Highest incidence in 20-60 year olds
More common in females
What does the radius articulate with
The capitulum of the humerus and the proximal ulna
What is the Mechanism of injury of the radial head fractures
Indirect trauma - axial loading of the forearm causing the radial head to push against the capitulum of the humerus
Most commonly the arm will be in pronation and extension
What are the clinical features of radial head fractures
History of FOOSH
Elbow pain
Tenderness over the lateral aspect of elbow
Crepitation on supination and pronation
Shoulder and wrist joint should be examined
What are the investigations for suspected radial head fracture
Routine bloods
Group and save
Plain AP and lateral radiographs - 1st line investigations ( can also do the joints above and below )
CT for more complex injuries if there is any comminution
What is sail sign
Effusion from the elbow on the lateral radiograph
How are radial head fractures classified
According to the degree of displacement using the mason classification
What is mason 1
Non displaced/ minimum displacement of less than 2mm
what is mason 2
Partial fracture with greater than 2mm displacement or angulation
what is mason 3
Comminuted fracture and displacement
What is the management of the patient prior to definitive management
Analgesia
Adequately resuscitated
What is the definitive management for mason 1
Non operative, short period of immobilisation with sling (less than 1 week ) with early mobilisation
what is the definitive management for mason 2
If no mechanical block => type 1 treatment
If mechanical block => open reduction internal fixation ( ORIF )
what is the definitive management of mason 3
Surgical intervention,
Either ORIF or radial head excision/replacement
What is a Essex lopresti fracture
fracture of the radial head with disruption of the distal radio-ulnar joint
