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
          - ref: ORIF vs radial head arthroplasty in the treatment of adult closed comminuted radial head frx (modified Mason type III and IV).

                     

 




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

Last updated by Clifford R. Wheeless, III, MD on Monday, July 6, 2015 6:09 pm