Radial head fracture: Difference between revisions
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==Background== | ==Background== | ||
*Most common fractures of the elbow | *Most common fractures of the elbow, approx 20% of elbow fx | ||
*Caused by FOOSH 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: | *Associated injuries are common: | ||
**Capitellum, olecranon, and coronoid fx, MCL injury, dislocation | **Capitellum, olecranon, and coronoid fx, MCL injury, elbow dislocation, DRUJ (distal radial ulnar joint) injury, interosseous membrane disruption, terrible triad (radial head fx, capitellar fx, elbow dislocation. | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 01:48, 13 June 2016
Background
- Most common fractures of the elbow, approx 20% of elbow fx
- Caused by FOOSH in pronation leading to radial head being driven into the capitellum
- Associated injuries are common:
- Capitellum, olecranon, and coronoid fx, MCL injury, elbow dislocation, DRUJ (distal radial ulnar joint) injury, interosseous membrane disruption, terrible triad (radial head fx, capitellar fx, 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