Radial Head Fractures

  • Benjamin Richards Wagner
  • C. Liam DwyerEmail author


Radial head fractures are extremely common but remain a challenging fracture to treat for orthopedic surgeons. They typically have associated soft tissue and osseous injuries that should not go unnoticed. The role of the radial head in elbow stability is of paramount importance in treatment. Knowledge of the complex anatomy of the elbow is key to treating these injuries. Appropriate workup includes a complete physical exam and imaging studies, including both x-rays and CT scans if necessary. The modified Mason classification can help guide treatment and is based on imaging and physical exam findings. Nondisplaced fractures with no mechanical block to motion can be treated nonoperatively with emphasis on early motion to prevent stiffness. Displaced fractures, those with mechanical block to motion or associated injuries, are treated surgically. Displaced fractures with three or less fragments have good results with open reduction and internal fixation. Fractures with greater than three fragments do better with radial head replacement than fixation. Fragment excision and radial head resection are treatment options that have a limited indication. Choosing the appropriate treatment can lead to the best patient outcomes.


Radial head Fracture Arthroplasty Mason classification 


  1. 1.
    Duckworth A, Clement N, Jenkins P, Aitken S, Court-Brown C. The epidemiology of radial head and neck fractures. J Hand Surg Am. 2012;37(1):112–9.CrossRefGoogle Scholar
  2. 2.
    Kaas L, van Riet R, Vroemen J, Eygendaal D. The epidemiology of radial head fractures. J Shoulder Elbow Surg. 2010;19(4):520–3.CrossRefGoogle Scholar
  3. 3.
    Halls A, Travill A. Transmission of pressures across the elbow joint. Anat Rec. 1964;150(3):243–7.CrossRefGoogle Scholar
  4. 4.
    Greenspan A. Orthopedic imaging. 1st ed. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins; 2011.Google Scholar
  5. 5.
    Kaas L, van Riet R, Turkenburg J, Vroemen J, van Dijk C, Eygendaal D. Magnetic resonance imaging in radial head fractures: most associated injuries are not clinically relevant. J Shoulder Elbow Surg. 2011;20(8):1282–8.CrossRefGoogle Scholar
  6. 6.
    Mason M. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32.CrossRefGoogle Scholar
  7. 7.
    Johnston G. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962;31:51–6.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Broberg M, Morrey B. Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987;(216):109–19.Google Scholar
  9. 9.
    Smith G, Hotchkiss R. Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. J Shoulder Elbow Surg. 1996;5(2):113–7.CrossRefGoogle Scholar
  10. 10.
    Lindenhovius A, Felsch Q, Ring D, Kloen P. The long-term outcome of open reduction and internal fixation of stable displaced isolated partial articular fractures of the radial head. J Trauma Inj Infect Crit Care. 2009;67(1):143–6.CrossRefGoogle Scholar
  11. 11.
    Lindenhovius A, Felsch Q, Doornberg J, Ring D, Kloen P. Open reduction and internal fixation compared with excision for unstable displaced fractures of the radial head. J Hand Surg Am. 2007;32(5):630–6.CrossRefGoogle Scholar
  12. 12.
    Ring D, Quintero J, Jupiter J. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg. 2002;84A:1811–5.CrossRefGoogle Scholar
  13. 13.
    Chen X, Wang S, Cao L, Yang G, Li M, Su J. Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial head fractures. Int Orthop. 2011;35(7):1071–6.CrossRefGoogle Scholar
  14. 14.
    Koslowsky T, Schliwa S, Koebke J. Presentation of the microscopic vascular architecture of the radial head using a sequential plastination technique. Clin Anat. 2011;24(6):721–32.CrossRefGoogle Scholar
  15. 15.
    Doornberg J, Linzel D, Zurakowski D, Ring D. Reference points for radial head prosthesis size. J Hand Surg Am. 2006;31(1):53–7.CrossRefGoogle Scholar
  16. 16.
    Beingessner D, Dunning C, Gordon K, Johnson J, King G. The effect of radial head fracture size on elbow kinematics and stability. J Orthop Res. 2005;23(1):210–7.CrossRefGoogle Scholar
  17. 17.
    Broberg M, Morrey B. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am. 1986;68(5):669–74.CrossRefGoogle Scholar
  18. 18.
    Eygendaal D. Radial head fractures. In: Pederzini L, Eygendaal D, Denti M, editors. Elbow and sport. Berlin, Heidelberg: Springer; 2016.Google Scholar
  19. 19.
    Barco R, Ballesteros JR, Llusá M, Antuña S. Applied anatomy and surgical approaches to the elbow. In: Antuña S, Barco R, editors. Essentials in elbow surgery. London: Springer; 2014.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of OrthopaedicsGeisinger Medical CenterDanvilleUSA

Personalised recommendations