The radial head is posterior to the capitellum, which is possibly related to the spontaneous reduction of a dislocated elbow. The fracture is more evident on the lateral view. Immediate orthopaedic referral required.įigure 7: AP and lateral view of a thirteen year old girl with a completely displaced fracture of the radial neck. The injury could be easily missed if only the lateral view is examined. Displaced fracture of radial neckįigure 6: Sixteen year old boy with a completely displaced and severely angulated (almost 90 degrees) radial head fracture (white arrow). Monteggia variant injury requiring immediate orthopaedic referral. The radial head should point to the capitellum in all views (Figure 3).įigure 4: Fourteen- year- old boy with displaced Salter Harris type I fracture of the proximal radius and avulsion of the medial epicondyle - this demonstrates the valgus nature of the force which has caused both injuries.įigure 5: Four year old girl with a displaced Salter-Harris type II fracture of the proximal radius in association with a fracture of the proximal ulna (olecranon) - this is a In this situation, a separate AP view of the proximal radius may be needed to better assess the displacement (Figure 2).įigure 2: True AP view of proximal radius. If the patient is unable to fully extend the elbow, the AP view of the elbow may not be a true AP view of the radius (Figure 1). This is to ensure that the views obtained of the proximal radius are orthogonal. The degree of forearm rotation should be the same in each view (e.g. What radiological investigations should be ordered?Īnteroposterior (AP) and lateral view of the elbow should be ordered. elbow joint dislocation, ulna shaft fracture). Inability to perform this movement (either due to mechanical obstruction or severe pain) should prompt investigation for a more complex injury pattern.ĭeformity is not typically a feature unless there are associated injuries (e.g. There is usually pain, tenderness, and swelling over the lateral aspect of the elbow and decreased forearm rotation (pronation/supination). They can also occur as a result of a dislocation and subsequent manual reduction of the elbow joint. The most common mechanism is a fall onto the outstretched arm with a valgus stress at the elbow. Radial neck fractures account for 8% of all elbow fractures in children. How common are they and how do they occur? It is important to distinguish between these as the treatment and outcome can vary significantly.ģ. It is important to distinguish between these as the treatment and outcome can vary significantly.presence of elbow joint dislocation/relocation - see.
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