Radial head fracture

Clinical:

  • A 27 years old man
  • Alleged MVA, motorbike skidded
  • Complaints of painful swelling of right elbow
Radiograph of elbow in lateral view
Radiograph of elbow in AP view

Radiographic findings:

  • A minimally displaced fracture is seen involving the radial head (red arrow)
  • There is extension of fracture line to involve the articular surface (yellow arrow)
  • Positive anterior and posterior fat pad signs are seen (white arrows)
  • Associated soft tissue injury medial side of the elbow

Diagnosis: Fracture of radial head (Type II according to Mason classification)

Discussion:

  • Radial head fracture is a common injury (half of adult elbow fractures)
  • Most common cause of positive fat pad signs in adult
  • Undisplaced fracture may be occult and requires several radiographic projections
  • Mason classification of radial head fractures:
    • type I: non-displaced radial head fractures (or small marginal fractures), also known as a “chisel” fracture
    • type II: partial articular fractures with displacement (>2 mm)
    • type III: comminuted fractures involving the entire radial head
    • type IV: fracture of the radial head with dislocation of the elbow joint

 

Author: radhianahassan