Radial head fractures – update on classification and management

Radial head fractures require careful assessment and appropriate treatment to prevent disability from stiffness, deformity, post-traumatic arthritis, or other serious complications. Most undisplaced fractures are treated non-surgically, the main emphasis being focussed on early mobilization in order to achieve good results. The treatment of more complex radial head fractures associated with, or without, elbow instability remains controversial with the surgical choices ranging between open reduction and internal fixation and radial head excision – either early or late, with the option of radial head replacement to be considered. Simple, early excision of the radial head has more recently been reported to result in an unfavourable outcome in a significant number of cases. The Mason classification is widely used and guides the treatment plan. Understanding the mechanisms of normal elbow function and practising good surgical technique are crucial in the management of these injuries. This article discusses the aetiology, mechanism of injury, classification and management of radial head fractures.