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Radial head fracture. A potentially complex injury
P A Davidson1, J B Moseley, H S Tullos
1Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX 77030.
Clinical Orthopaedics and Related Research
|December 1, 1993
Summary
Radial head fracture patterns predict elbow instability. Comminuted or displaced radial head fractures often indicate associated medial collateral ligament injuries and valgus elbow instability, while minimally displaced fractures are typically stable.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Radiology
Background:
- Radial head fractures are common elbow injuries.
- Associated soft-tissue injuries, particularly to the medial collateral ligament (MCL), can significantly impact elbow stability and patient outcomes.
- Accurate assessment of fracture morphology is crucial for identifying these associated injuries.
Purpose of the Study:
- To evaluate the relationship between radial head fracture morphology and the presence of associated soft-tissue injuries, specifically medial elbow ligament competence and axial stability of the radius.
- To determine if fracture patterns can predict the likelihood of instability.
Main Methods:
- Prospective study of 50 patients with acute radial head fractures.
- Clinical examination and stress testing, including valgus stress radiography and axial stress tests, were performed.
- Fracture morphology was classified based on type and displacement.
Main Results:
- Comminuted radial head fractures (22%) were associated with valgus or axial instability.
- Displaced vertical shear or impacted radial neck fractures (34%) correlated with medial collateral ligament injury and valgus elbow instability.
- Minimally or nondisplaced fractures (44%) were consistently stable.
Conclusions:
- Radial head fracture morphology is a reliable indicator of associated soft-tissue injury.
- Specific fracture patterns, such as comminution and displacement, are predictive of elbow instability.
- This assessment aids in guiding treatment and managing expectations for patients with radial head fractures.