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Treatment for radial head fracture8/31/2023 ![]() A stable type 1 radial head fracture is typically managed with conservative measures including joint aspiration, immobilization in a sling for a few days and followed by early range of motion exercises. An unstable fracture will involve fracture displacement, fractures to adjacent structures and injury to other associated soft tissues. Radial head fracture treatment is informed by the Mason-Johnston classification, patient symptoms, and fracture stability. Radial head fracture seen on 3D CT reconstruction Radial head fracture with dislocation of the elbow Minimal displacement with angulation or impression (>2mm) Mason-Johnston Classification of Radial Head Fractures Ī diagnosed radial head fracture can be classified according to the Mason-Johnston system. A fat pad sign may be present on diagnostic imaging and may indicate a radial head fracture. Diagnostic imaging may include ultrasound, plain radiography (x-ray imaging), Computed tomography scan (CT), and magnetic resonance imaging (MRI). ![]() Clinical assessment may include pain or tenderness at the radial head, bruising, swelling, and a limited range of motion of the injured elbow. Radial head fractures are diagnosed from a clinical assessment and diagnostic imaging. Common adverse outcomes include stiffness, pain, poor bone healing, and hardware complications. Unstable fractures with other associated injuries have varying outcomes. Stable isolated fractures typically have excellent outcomes. Treatment may be surgical or nonsurgical. A radial head fracture is treated according to the severity of the injury and its Mason-Johnston classification. Radial head fractures are diagnosed by a clinical assessment and medical imaging. They account for approximately one third of all elbow fractures and are frequently associated with other injuries of the elbow. Radial head fractures are a common type of elbow fracture that typically occurs after a fall on an outstretched arm. Varies according to severity of injury but may include: immobilization followed by range of motion exercises joint aspiration with mobilization surgical correction Pain or tenderness over the radial head bruising swelling limited range of motion.īased on of clinical symptoms and medical imaging Treatment of radial head fractures depends on the specific characteristics of the fracture using the Mason classification.Radial head fracture (red arrow) with posterior and anterior sail sign (blue arrows) Radial head fractures may be difficult to visualize on initial imaging but should be suspected when there are limitations of elbow extension and supination following trauma. Combined fractures involving both the ulna and radius generally require surgical correction. These fractures are treated with immobilization or surgery, depending on the degree of displacement and angulation. Isolated midshaft ulna (nightstick) fractures are often caused by a direct blow to the forearm. It should be noted that these fractures may be complicated by a median nerve injury. A nondisplaced, or minimally displaced, distal radius fracture is initially treated with a sugar-tong splint, followed by a short-arm cast for a minimum of three weeks. In adults, distal radius fractures are the most common forearm fractures and are typically caused by a fall onto an outstretched hand. Depending on the degree of angulation, buckle and greenstick fractures can be managed with immobilization. Greenstick fractures, which have cortical disruption, are also common in children. Incomplete compression fractures without cortical disruption, called buckle (torus) fractures, are common in children. If initial imaging findings are negative and suspicion of fracture remains, splinting and repeat radiography in seven to 14 days should be performed. Evaluation with radiography or ultrasonography usually can confirm the diagnosis. A fall onto an outstretched hand is the most common mechanism of injury for fractures of the radius and ulna. Fractures of the radius and ulna are the most common fractures of the upper extremity, with distal fractures occurring more often than proximal fractures.
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