Radial head fracture: Difference between revisions
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==Background== | ==Background== | ||
*Most common fractures of the elbow, approx 20% of elbow | *Most common fractures of the elbow, approx 20% of elbow fractures | ||
*Caused by FOOSH in pronation leading to radial head being driven into the capitellum | *Caused by FOOSH in pronation leading to radial head being driven into the capitellum | ||
** | ===Associated injuries (are common)=== | ||
*[[Capitellum facture]] | |||
*[[Olecranon fracture]] | |||
*[[Coronoid fracture]] | |||
*MCL injury | |||
*[[Elbow dislocation ]] | |||
*DRUJ (distal radial ulnar joint) injury | |||
*Interosseous membrane disruption | |||
*Terrible triad (radial head fracture, [[capitellar fracture]], [[elbow dislocation]]) | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 11:56, 15 June 2016
Background
- Most common fractures of the elbow, approx 20% of elbow fractures
- Caused by FOOSH in pronation leading to radial head being driven into the capitellum
Associated injuries (are common)
- Capitellum facture
- Olecranon fracture
- Coronoid fracture
- MCL injury
- Elbow dislocation
- DRUJ (distal radial ulnar joint) injury
- Interosseous membrane disruption
- Terrible triad (radial head fracture, capitellar fracture, elbow dislocation)
Clinical Features
- Pain in the lateral elbow, especially with pronation/supination of forearm
- Swelling laterally and tenderness of radial head
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Diagnosis
- Elbow X-ray
- Fractures are often subtle
- Look for abnormal fat pad
- Look for radiocapitellar line disruption
- Greenspan View X-Ray
- If possible, lateral elbow is shot at 45 degrees to pick up subtle fractures
- Fractures are often subtle
Management
- Sling immobilization in flexion, ice, elevation
- Nondisplaced fracture with no mobility restrictions: ortho f/u within 1wk
- Displaced fracture or mobility restrictions: ortho f/u within 24hr
Disposition
- Normally outpatient