Abstract
Radial head and olecranon process fractures are among most common fractures in the elbow. A detailed history and examination can provide information on the probability of injuries. Both anteroposterior and lateral radiographs should be obtained to diagnose. MRI scans are helpful for evaluating soft tissue injuries. Intra-articular fragments or impacted fractures can be identified much better on CT scans. The Mason classification is the accepted classification system for fractures of the radial head. There are several classification systems which are described for olecranon process fractures, but neither has been accepted indeed. Nondisplaced and stable, minimally displaced partial articular fractures are treated nonoperatively. Open reduction and internal fixation provide a stable articular surface fixation and restoration of articular congruencies. Excision and prosthetic replacement might be necessary in comminuted and unstable fractures. Many treatment techniques have been described including tension band wire and plating.
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Akesson T, Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Karlsson MK (2006) Primary nonoperative treatment of moderately displaced two-part fractures of the radial head. J Bone Joint Surg Am 88:1909–1914
Audigé L, Bhandari M, Kellam J (2004) How reliable are reliability studies of fracture classifications? A systematic review of their methodologies. Acta Orthop Scand 75:184–194
Bain GI, Ashwood N, Baird R, Unni R (2005) Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. Surgical technique J Bone Joint Surg Am 87(Suppl 1):136–147
Bernstein J, Monaghan BA, Silber JS, DeLong WG (1997) Taxonomy and treatment: a classification of fracture classifications. J Bone Joint Surg Br 79:706–707
Boulas HJ, Morrey BF (1998) Biomechanical evaluation of the elbow following radial head fracture. Comparison of open reduction and internal fixation vs. excision, silastic replacement, and non-operative management. Chir Main 17:314–320
Broberg MA, Morrey BF (1987) Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res 216:109–119
Davidson PA, Moseley JB Jr, Tullos HS (1993) Radial head fracture. A potentially complex injury Clin Orthop Relat Res 297:224–230
Doornberg JN, Parisien R, van Duijn PJ, Ring D (2007) Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. J Bone Joint Surg Am 89:1075–1080
Dotzis A, Cochu G, Mabit C, Charissoux JL, Arnaud JP (2006) Comminuted fractures of the radial head treated by the Judet floating radial head prosthesis. J Bone Joint Surg Br 88:760–764
Dubberley JH, Faber KJ, Macdermid JC, Patterson SD, King GJ (2006) Outcome after open reduction and internal fixation of capitellar and trochlear fractures. J Bone Joint Surg Am 88:46–54
Duckworth AD, Clement ND, Aitken SA et al (2012a) The epidemiology of fractures of the proximal ulna. Injury 43:343–346
Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM (2012b) The epidemiology of radial head and neck fractures. J Hand Surg Am 37:112–119
Duckworth AD, Clement ND, Jenkins PJ, Will EM, Court-Brown CM, McQueen MM (2012c) Socioeconomic deprivation predicts outcome following radial head and neck fractures. Injury 43:1102–1106
Esser RD, Davis S, Taavao T (1995) Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma 9:318–323
Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ (2006) Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes J Bone Joint Surg Am 88:2192–2200
Grundy A, Murphy G, Barker A, Guest P, Jack L (1985) The value of the radial head-capitellum view in radial head trauma. Br J Radiol 58:965–967
Guitton TG, Ring D, Science of Variation Group (2011) Interobserver reliability of radial head fracture classification: two-dimensional compared with three dimensional CT. J Bone Joint Surg Am. 93:2015–2021
Hall-Craggs M, Shorvon PJ, Chapman M (1985) Assessment of the radial head-capitellum view and the dorsal fat-pad sign in acute elbow trauma. AJR Am J Roentgenol 145:607–609
Herbertsson P, Josefsson PO, Hasserius R et al (2004) Uncomplicated Mason type-II and III fractures of the radial head and neck in adults. A long-term follow-up study. J Bone Joint Surg Am 86:569–574
Horsfield D, Siegerist CF (2005) Radiography of the radial head: an alternative view. Radiography 11:201–206
Hume MC, Wiss DA (1992) Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res 285:229–235
Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y (2005) Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am 87:76–84
Jackson JD, Steinmann SP (2007) Radial head fractures. Hand Clin 23:185–193
Johnson JA, Beingessner DM, Gordon KD, Dunning CE, Stacpoole RA, King GJ (2005) Kinematics and stability of the fractured and implant-reconstructed radial head. J Shoulder Elbow Surg 14(Suppl 1):195–201
Johnston GW (1962) A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J 31:51–56
Kaas L, Sierevelt IN, Vroemen JP, van Dijk CN, Eygendaal D (2012) Osteoporosis and radial head fractures in female patients: a case control study. J Shoulder Elbow Surg 21:1555–1558
Kaas L, van Riet RP, Vroemen JP, Eygendaal D (2010a) The epidemiology of radial head fractures. J Shoulder Elbow Surg 19:520–523
Kaas L, Turkenburg JL, van Riet RP et al (2010b) Magnetic resonance imaging findings in 46 elbows with a radial head fracture. Acta Orthop 81:373–376
Khalfayan EE, Culp RW, Alexander AH (1992) Mason type II radial head fractures: operative versus nonoperative treatment. J Orthop Trauma 6:283–289
King GJ, Evans DC, Kellam JF (1991) Open reduction and internal fixation of radial head fractures. J Orthop Trauma 5:21–28
Lindenhovius AL, Felsch Q, Doornberg JN, Ring D, Kloen P (2007) Open reduction and internal fixation compared with excision for unstable displaced fractures of the radial head. J Hand Surg Am 32:630–636
Lindenhovius AL, Felsch Q, Ring D, Kloen P (2009) The long-term outcome of open reduction and internal fixation of stable displaced isolated partial articular fractures of the radial head. J Trauma 67:143–146
Manns RA, Lee JR (1990) Critical evaluation of the radial head-capitellum view in acute elbow with an effusion. Clin Radiol 42:433–436
Mason ML (1954) Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg 42:123–132
McKee MD, Seiler JG, Jupiter JB (1995) The application of the limited contact dynamic compression plate in the upper extremity: an analysis of 114 consecutive cases. Injury 26:661–666
Morewood DJ (1987) Incidence of unsuspected fractures in traumatic effusions of the elbow joint. Br Med J (Clin Res Ed) 295:109–110
Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ (2001) Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am 83:1201–1211
Muller ME, Allgower M, Schneider R, Willenegger H (eds) (1991) Manual of internal fixation: techniques recommended by the AO-ASIF group, 3rd edn. Springer-Verlag, Berlin
Page AC (1986) Critical evaluation of the radial head-capitellum view in elbow trauma. AJR Am J Roentgenol 146:81–82
Pearce MS, Gallannaugh SC (1996) Mason type II radial head fractures fixed with Herbert bone screws. J R Soc Med 89:340–344
Popovic N, Gillet P, Rodriguez A, Lemaire R (2000) Fracture of the radial head with associated elbow dislocation: results of treatment using a floating radial head prosthesis. J Orthop Trauma 14:171–177
van Riet RP, Morrey BF, O’Driscoll SW, Van Glabbeek F (2005) Associated injuries complicating radial head fractures: a demographic study. Clin Orthop Relat Res 441:351–355
Ring D (2010) Elbow fractures and dislocations. In: Bucholz RW, Court-Brown CM, Heckman JD et al (eds) Rockwood and Green’s fractures in adults, 7th edn. Lippincott Williams & Wilkins, Philadelphia, pp 905–944
Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am 84:1811–1815
Rochwerger A, Bataille JF, Kelberine F, Curvale G, Groulier P (1996) Retrospective analysis of 78 surgically repaired fractures of the radial head. Acta Orthop Belg 62(Suppl 1):87–92
Rolla PR, Surace MF, Bini A et al (2006) Arthroscopic treatment of fractures of the radial head. Arthroscopy 22(2):233.e1–233.e6
Ruan HJ, Fan CY, Liu JJ, Zeng BF (2009) A comparative study of internal fixation and prosthesis replacement for radial head fractures of Mason type III. Int Orthop 33:249–253
Rouleau DM, Sandman E, van Riel R el al (2013) Management of fractures of the proximal ulna. J Am Acad Orthop Surg 21:149–160
Sartoris DJ, Resnick D (1988) Plain film radiography: routine and specialized technique and projections. In: Resnick D, Nijwayama G (eds) Diagnosis of bone and joint disorders, 2nd edn. WB Saunders, Philadelphia, PA, pp 2–54
Schatzker J (1996) Fractures of the olecranon. In: Schatzker J, Tile M (eds) The rationale of operative fracture care. Springer-Verlag, New York, NY, pp 113–119
Sheps DM, Kiefer KR, Boorman RS et al (2009) The interobserver reliability of classification systems for radial head fractures: the Hotchkiss modification of the Mason classification and the AO classification systems. Can J Surg 52:277–282
Simpson NS, Goodman LA, Jupiter JB (1996) Contoured LCDC plating of the proximal ulna. Injury 27:411–417
Smets S, Govaers K, Jansen N, Van Riet R, Schaap M, Van Glabbeek F (2000) The floating radial head prosthesis for comminuted radial head fractures: a multicentric study. Acta Orthop Belg 66:353–358
Sormaala MJ, Sormaala A, Mattila VM et al (2014) MDCT findings after elbow dislocation: a retrospective study of 140 patients. Skelet Radiol 43:507–512
Timmerman LA, Schwartz ML, Andrews JR (1994) Preoperative evaluation of the ulnar collateral ligament bymagnetic resonance imaging and computed tomography arthrography. Evaluation in 25 baseball players with surgical confirmation. Am J Sports Med 22:26–31
Unsworth-White J, Koka R, Churchill M, D’Arcy JC, James SE (1994) The non-operative management of radial head fractures: a randomized trial of three treatments. Injury 25:165–167
Veillette CJH Steinmann SP (2008) Olecranon fractures. Orthop Clin N Am 39:229–236
Wiegand L, Bernstein J, Ahn J (2012) Fractures in brief: Olecranon fractures. Clin Orthop Relat Res 470:3637–3641
Wijeratna M, Bailey KA, Pace A et al (2012) Arthroscopic radial head excision in managing elbow trauma. Int Orthop 36:2507–2512
Wolfgang G, Burke F, Bush D et al (1987) Surgical treatment of displaced olecranon fractures by tension band wiring technique. Clin Orthop Relat Res 224:192–204
Yoon A, Athwal GS, Faber KJ, King GJW (2012) Radial head fractures. J Hand Surg Am 37:2626–2634
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Huri, G., Cetinkaya, N.S., Doral, M.N. (2019). Radial Head and Olecranon Process Fractures. In: Doral, M., Karlsson, J., Nyland, J., Benedetto, K. (eds) Intraarticular Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-97602-0_15
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