Skip to main content
SpringerLink
Log in

Radial Head Fractures

  • Chapter
  • First Online:
Tips and Tricks for Problem Fractures, Volume I

  • 598 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  3. Halls A, Travill A. Transmission of pressures across the elbow joint. Anat Rec. 1964;150(3):243–7.

    Article  CAS  Google Scholar 

  4. Greenspan A. Orthopedic imaging. 1st ed. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins; 2011.

    Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    CAS  PubMed  PubMed Central  Google Scholar 

  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. 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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  18. Eygendaal D. Radial head fractures. In: Pederzini L, Eygendaal D, Denti M, editors. Elbow and sport. Berlin, Heidelberg: Springer; 2016.

    Google Scholar 

  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 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Geisinger Medical Center, Danville, PA, USA

    Benjamin Richards Wagner & C. Liam Dwyer

Authors
  1. Benjamin Richards Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Liam Dwyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Liam Dwyer .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Geisinger Health System, Geisinger Musculoskeletal Institute, Danville, PA, USA

    Daniel S. Horwitz

  2. Department of Orthopedic Surgery, Geisinger Medical Center, Danville, PA, USA

    Michael Suk

  3. Department of Orthopedic Surgery, Geisinger Medical Center, Danville, PA, USA

    Teresa K. Swenson

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wagner, B.R., Dwyer, C.L. (2020). Radial Head Fractures. In: Horwitz, D., Suk, M., Swenson, T. (eds) Tips and Tricks for Problem Fractures, Volume I. Springer, Cham. https://doi.org/10.1007/978-3-030-38274-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-38274-2_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-38273-5

  • Online ISBN: 978-3-030-38274-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation