Radial head and neck fractures in adults
- Mark Slabaugh, MD
Mark Slabaugh, MD
- Assistant Professor of Surgery
- Uniformed Services University of Health Sciences
- Assistant Director of Sports Medicine Research
- Wilford Hall Medical Center, Lackland AFB
Radial head and neck fractures occur frequently, most often following a fall onto an outstretched hand. Nondisplaced fractures can be managed by knowledgeable, primary care physicians; orthopedic referral is needed for more complex fractures.
The presentation, evaluation, and basic management of radial head and neck fractures are reviewed here. The management of pediatric elbow fractures and other upper extremity injuries is discussed separately. (See "Elbow anatomy and radiographic diagnosis of elbow fracture in children" and "Evaluation of elbow pain in adults" and "Distal radius fractures in adults".)
EPIDEMIOLOGY AND RISK FACTORS
Some studies describe a male predominance with a ratio of 2:1, but others describe equal distribution between genders [4,5]. On average, fractures in men occur seven years earlier than in women . Radial head fractures occur throughout adulthood; the mean age at the time of injury is approximately 45 years. Fractures of the radial neck occur most often in children and are much less common in adults.
The radial head and neck comprise the most proximal portion of the radius (figure 1 and figure 2 and figure 3). The radial head lies at the proximal end. It is disk-shaped with a flattened end that articulates with the capitellum of the humerus proximally. The radial head also articulates with the lesser sigmoid notch of the ulna medially. Just distal to the head but proximal to the tuberosity is the radial neck, which is narrower than the head and slightly concave.
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- EPIDEMIOLOGY AND RISK FACTORS
- FUNCTIONAL ANATOMY
- MECHANISM OF INJURY
- CLINICAL PRESENTATION AND EXAMINATION
- RADIOGRAPHIC FINDINGS
- INDICATIONS FOR ORTHOPEDIC REFERRAL
- INITIAL MANAGEMENT
- Goals of care
- Basic treatment
- Limited joint motion
- PROGNOSIS AND COMPLICATIONS
- RETURN TO SPORT OR WORK
- SUMMARY AND RECOMMENDATIONS