Radial head fracture

This page is for adult patients; see radial head fracture (peds) for pediatric patients

Background

  • Most common fractures of the elbow, approximately 20% of elbow fractures
  • Caused by FOOSH in pronation leading to radial head being driven into the capitellum

Associated injuries (are common)

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

Radiograph-Negative

Pediatric

Evaluation

Workup

  • Elbow PA & lateral
  • Consider x-rays of humerus, forearm, and wrist (e.g. to rule out a Essex-Lopresti fracture)
  • Consider Greenspan (radial head-capitellum) view X-Ray
    • Lateral elbow is shot at 45 degrees to pick up subtle fractures

Diagnosis

  • Ensure there is no tenderness over the rest of the forearm/wrist to rule out an Essex-Lopresti fracture
  • Typically diagnoses on x-ray (fractures are often subtle)
    • Look for abnormal fat pad
    • Look for radiocapitellar line disruption
    • See elbow X-ray

Management

  • Sling immobilization in flexion, ice, elevation
  • Nondisplaced fracture with no mobility restrictions: ortho follow up within 1wk
  • Displaced fracture or mobility restrictions: ortho follow up within 24hr

Disposition

  • Normally outpatient

See Also

References