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FRACTURES OF THE RADIAL
HEAD AND NECK
The radial head is important for pronation and supination of
the forearm as well as for flexion and extension motions at
the elbow. Fractures are classified by the articular involvement
(Figure 18.23).
Evaluation
Patients have pain and swelling over the lateral aspect of
the elbow. Some motion remains in minimally displaced fractures.
X-rays confirm the diagnosis.
Treatment
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Treat
fractures with minimal displacement in an arm sling
and begin motion when comfortable. |
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ITo
reduce displaced fractures of the radial neck:
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Place
your thumb over the radial head and apply longitudinal
traction with a varus stress to the arm |
| • |
Gently
rotate the forearm while applying medial pressure
with your thumb to the radial head |
| • |
Place
the arm in a long arm splint |
| • |
Begin
motion out of the splint at 3 weeks. |
|
| :: |
Treat
comminuted or displaced intra-articular fractures
with early motion. If available, alternatives are
surgical stabilization or radial head excision. |
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In fractures with minimal displacement,
treat with closed reduction and a posterior splint and
begin motion as soon as comfortable
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 |
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Treat displaced intra-articular fractures
with early motion and consider surgical treatment, if
available.
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