![]() ![]() MRI may be used to assess for possible osteochondral injuries of either the radial head itself or, more commonly, of the capitellum. Additionally, a positive fat pad sign on a lateral view indicates fluid in the joint, which in the acute setting is usually blood suggestive of a fracture (Figure 2).ĬT scanning may be used for preoperative planning, especially in the case of fragment displacement or comminution. Oblique views with the forearm in neutral rotation, so-called Greenspan views, show the radiocapitellar articulation and may be useful in the case of a suspected fracture that is not visible on AP or lateral films. A fracture of the radial head with concomitant dislocation of the distal radio-ulnar joint is called an "Essex-Lopresti fracture." The distal radio-ulnar joint should be assessed on the lateral film for dislocation. Radiographs must be obtained in the case of suspected elbow fracture standard anteroposterior (AP) and lateral films of the elbow and of the wrist usually suffice. Aspiration of the effusion may assist with diagnosis and provide pain relief, thereby allowing faster and more effective rehabilitation. Intra-articular bleeding from the fracture may produce a palpable effusion. There is typically localized tenderness over the radial head on palpation passive rotation of the forearm is also painful. Pain, effusion over the elbow, and limited range of motion at the elbow and forearm are common symptoms. Patients with an injury to the radial head typically present with a history of a fall on an outstretched hand, or, following higher energy trauma and elbow dislocation. In particular, loss of the radial head may cause wrist symptoms, as such loss may cause proximal migration of the radius with additional load now placed on the proximal ulna. The radial head also ultimately connects to the carpus, as it is the base on which the radius itself is supported. (The central axis of the radius is not perfectly cylindrical, and thus during pronation, the radius must be able to translate a bit as well). This ligament holds the radius as it rotates, but also allows for some translation as well. Just distal to the radial head lies the annular ligament, which holds the radius to the ulna. The radial head translates on the capitellum during elbow flexion-extension, and pivots on the capitellum during supination-pronation. The radial head is concave, matching the convex surface of the capitellum of the humerus (Figure 2). The radial head articulates with both the capitellum of the humerus and the ulna. The impact from the fall drives the radius proximally into the humerus, causing an injury at the elbow. Perhaps counter-intuitively, fractures of the radial head (which is part of the elbow) typically occur after a fall on an outstretched hand. ![]() Depending on the selected prosthesis, your broken radius will be sized and an artificial one put back in its place.Radial head fractures are the most common type of elbow fractures in adults. Your elbow is opened from the front side of your forearm and the fractured radial head is removed. Pyrocarbon, lighter with strong recent results.Cobalt chrome, heavier with longer clinical data.The goal of radial head replacement surgery is to replace the fragmented radial head at the elbow with a prosthetic one.ĭr Gupta will choose between radial head prosthesis composition: ![]() If a fractured elbow (radial head) is too badly displaced or separated, it may not be able to be repaired and a radial head replacement may be necessary. Type III radial head fractures are indicated for surgery and will require open reduction internal fixation (ORIF surgery). Type I and type II radial head fractures at the elbow may be treated conservatively (non-surgically) with immobilisation, rest, pain and anti-inflammatory medication and with physiotherapy treatment after 6 weeks of immobilisation for improved strength and better elbow function. Treatment of a radial head fracture at the elbow should always begin with a thorough diagnosis of your condition to understand the severity of the condition in the context of your age, your sport, your work and your life. ![]()
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