Orthopedics Book

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Radial Head FractureAka: Radial Neck Fracture

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  1. Etiology
    1. Fall on Outstretched Hand with elbow extended
  2. Signs
    1. Tenderness over radial head
    2. Local swelling
    3. Pain on forearm rotation or elbow flexion
  3. Management: Adult
    1. Non-displaced or minimally displaced Radius Fracture
      1. Conservative Management
        1. Immobilize for 1-2 weeks with elbow at 90 degrees
          1. Light posterior splint
          2. Sling
        2. Continue Sling 1-2 wks after splint removed
      2. Exercises
        1. Early elbow range of motion Exercises
      3. Relief of severe pain from swelling
        1. Aspirate Elbow joint at posterolateral triangle
    2. Displaced or comminuted Radius Fracture
      1. Surgical excision of radial head with 24-48 hours
  4. Management: Child
    1. Non-displaced Fracture and <15-30 degrees angulation
      1. Management as for non-displaced Fracture in adults
    2. Displaced Fracture or >15-30 degrees angulation
      1. Reduction
        1. Closed
        2. Open reduction and internal fixation (ORIF)
      2. Radial head is never excised in growing child
        1. Epiphysis removal results in unequal forearm growth
  5. Prognosis
    1. Non-displaced Fracture or effective early reduction
      1. Expect some loss of elbow extension
      2. Minimal or no functional Impairment expected
    2. Delayed effective management of displaced Fracture
      1. Permanently restricted elbow Range of Motion
      2. Traumatic arthritis
        1. Fracture fragments act as nidus for calcification
        2. Myositis Ossificans ensues in anterior elbow region

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