Radial head fractures associated with elbow dislocations treated by immediate stabilization and early motion

Twenty-one elbow dislocations with an associated radial head Fracture were treated with immediate joint reduction, stabilization, and early range-of-m otion exercises. In all cases initial treatment involved closed reduction o f the ulnohumeral joint. For those cases involving minimally displaced and a few moderately displaced radial head fractures, treatment consisted of be nign neglect (4 of 21). Of the more severely displaced fractures (17 of 21) , 9 were treated with open-reduction internal fixation and 8 with immediate silicone head replacement. Despite radial head treatment, 6 of these cases remained unstable, prompting primary repair of collateral ligaments; 3 eve ntually required application of a hinged fixator as a salvage option. Resul ts confirmed that initial radial head displacement predicts functional outc ome. Our study demonstrates that fracture dislocations of the elbow demand a broad consideration of treatment options and that reconstruction of elbow stability requires either primary repair of collateral ligaments or the po ssible use of a hinged fixator device.