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Pediatric Radial Head Frx

- see Pediatric Radial Neck Frx

- 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.   

Intra-articular Radial Head Fracture in the Skeletally Immature Patient: Progressive Radial Head Subluxation and Rapid Radiocapitellar Degeneration