RADIAL HEAD FRACTURE - A POTENTIALLY COMPLEX INJURY

A prospective study was undertaken on 50 acute, consecutive fractures of the radial head. Clinical examination and stress testing were perfo rmed on each patient. A valgus stress radiograph, in conjunction with clinical stress testing, was used to assess competence of the medial e lbow ligaments. Axial stability of the radius was determined by the ax ial stress test. Eleven patients (22%) sustained a comminuted radial h ead fracture; all had instability either to valgus or axial stress. Se venteen patients (34%) had a displaced vertical shear type fracture or an impacted fracture of the radial neck. All sustained some injury to the medial collateral ligament, with variable degrees of valgus elbow instability. Twenty-two (44%) of the fractures were minimally or nond isplaced. All 22 were stable. Radial head fracture morphology can be u sed to assess the likelihood of associated soft-tissue injury.