Radial head fractures in adults

SummaryThe radial head is involved in both elbow flexion and extension as well as forearm rotation and is an important stabiliser of the elbow. Fractures account for one-third of elbow fractures in adults and can lead to marked disability. Radial head fractures can be part of a spectrum of injuries to the elbow leading to complex instability. Management of comminuted fractures is controversial, but the present trend is towards stabilisation to allow early mobilization. The majority of radial head fractures are undisplaced and do not require operative treatment. Associated injuries to the elbow potentially leading to instability should be sought. In comminuted fractures with an intact MCL where fixation is not possible excision gives satisfactory long-term results. If instability is present radial length should be restored either by ORIF or replacement and any associated bony or ligamentous injuries repaired to allow early mobilisation to prevent stiffness.