- Discussion:
- may be difficult to diagnose since radial head does not ossify until age 4 yrs;
- radial head frx may occur along w/ ulnar shaft frx (Monteggia equivalent);
- consider MRI or ultrasound to assist w/ diagnosis;
-
Salter Harris II frx:
- most common type of radial head and neck fractures in children;
- look for positive "sail" or posterior fat pad signs;
- look for anterior or posterior displacement of the radial head or
shaft, as determined by use of the radiocapitellar line;
- Reduction:
- manually reduce in full supination, and then pronate the forearm
as pressure is maintained over the radial head;
- GEA may be required;
- w/ failure of manual reduction, attempt reduction using percutaneous
K wires to lever and disimpact the radial head;
- strive for less than 20 deg angulation and less than 2 mm displacement;
- an oblique K wire may be required to hold reduction;
Displaced fractures of the head and neck of the radius in children: open
reduction and temporary transarticular internal fixation. [Review]
Treatment of chronic post-traumatic dislocation of the radial head in children.
Fractures of the radial head and associated elbow injuries in children.
