Radial head-capitellum view in elbow trauma: clinical application and radiographic-anatomic correlation

The radial head-capitellum view, first reported 2 years ago, has proved useful in the evaluation of elbow trauma. Minimally displaced or nondisplaced fractures of the radial head, capitellum, and coronoid process are better demonstrated on this special projection than on traditional radiographs of the elbow. To test the accuracy of this view, 50 patients with trauma to the elbow were examined and routine anteroposterior, lateral, and external oblique radiographs were compared with this special angled projection. In 10 patients, the conventional studies either were negative or failed to show the full extent of the fracture, whereas the radial head-capitellum view demonstrated the abnormality in every case. A human cadaver elbow specimen was used in a radiographic anatomic correlative study to further confirm the usefulness of this technique. It revealed that fractures of the posterior half of the radial head were particularly difficult to diagnose on the traditional lateral view. The radial head-capitellum view not only distinctly delineated these fractures, it showed the full extent of their articular displacement. The authors recommend the use of this technique in all cases of chronic and acute trauma to the elbow joint.