- 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: