[Fractures of the radial head and neck]

Fractures of the radial head and neck are the most common involving the elbow and account for 5 % of all fractures in adult individuals. Due to the complex anatomy and biomechanics of the elbow joint radial head fractures are challenging, particularly the comminuted ones. Detailed knowledge of the complex joint anatomy, biomechanics and operative approaches are indispensable for analysing and building a treatment plan. The aim of radial head fracture treatment is to restore the anatomy and joint kinematics, achieve a stable and pain-free range-of-motion and to avoid posttraumatic degenerative changes. Treatment depends on the type of fracture and accompanying injuries. It ranges from conservative treatment with early initiation of physical therapy to open reduction and internal fixation. Sophisticated reconstructive efforts with combined screw- and plate-osteosynthesis, partial resection or radial head arthroplasty are needed in comminuted fractures. The purpose of this article is to give a detailed review of the anatomy, biomechanics and fracture mechanism. Clinical examination techniques are displayed and operative approaches as well as the conservative and operative treatment algorithms are illustrated.