SOMOS Annual meeting
presents
Wheeless' Textbook of Orthopaedics

Type III Radial Head Fracture



- Discussion:
    - comminuted fractures of the entire head;
    - classification:
           - type A:
                  - fracture of the entire radial neck, with the head completely displaced from the shaft;
           - type B:
                  - articular fracture involving the entire head, which consists of more than two large fragments;
                  - each fragment is completely displaced from the shaft;
           - type C:
                  - fracture with a tilted and impacted articular segment, which must be reduced;
                  - articular fragments displaced from the shaft.
           - complex fractures:
                  - radial head frx & elbow dislocation :
                        - injury to medial collateral ligament w/ dislocation can be subtle;
                        - apply valgus stress to judge instability;
                  - radial head frx & MCL instability :
                  - Essex Lopresti Fracture

- Radiographs:
    - proximal translation of the radius;
          - it is important to have adequate views of the wrist early on inorder to follow proximal radial translation later on;


- Treatment Options:
    - w/ acute longitudinal radioulnar dissociation (Essex Lopresti Fracture), attempt to preserve radial head;
    - excision of radial head:
          - unlike type II fractures, these fractures do not do well w/ delayed excision; 
    - ORIF of radial head fracture
    - radial head implants

                     




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Tuesday, September 23, 2008 11:16 pm