Radial head fractures : Epidemiology, diagnosis, treatment and outcome

Abstract

Radial head fractures account for the majority of bony injuries to the elbow. The usual clinical signs include hemarthrosis, pain and limitations in movement. The standard diagnostic tool is radiological imaging using X‑rays and for more complex fractures, computed tomography (CT). Concomitant ligamentous injuries occur more frequently than expected and must be reliably excluded. The classification is based on the modified Mason classification. Mason typeI fractures are usually treated conservatively with immobilization and early functional aftercare. Mason typeII fractures can be well-addressed by screw osteosynthesis but higher grade fractures (Mason typesIII-IV) can necessitate a prosthetic radial head replacement. In this case, prosthesis implantation is to be preferred to aradial head resection. The outcome after treatment of radial head fractures can be described as good to very good if all accompanying injuries are adequately addressed.