Radial head fractures and dislocations are common injuries that occur at the elbow joint, particularly in adults and children, often resulting from falls on an outstretched hand or direct trauma. Radial head fractures specifically involve the radial head, the upper part of the radius bone that articulates with the humerus and the ulna at the elbow. They can be classified into three types according to the Mason classification system: Type I is a non-displaced fracture, Type II involves a displaced fracture with a single fragment, and Type III presents as comminuted fractures with multiple fragments. These injuries frequently occur in conjunction with elbow dislocations, where the ulna and radius are forced out of their normal alignment with the humerus, leading to a significant loss of functionality and motion at the elbow. Clinical presentation includes pain at the lateral aspect of the elbow, swelling, and difficulty in performing everyday activities such as lifting or twisting. When a dislocation occurs, there may also be deformity and acute pain, with patients often unable to extend the elbow fully or rotate the forearm. It's important for medical professionals to conduct a thorough physical examination and obtain imaging studies, typically X-rays, to accurately diagnose the type and extent of the fracture or dislocation. In some cases, additional imaging like an MRI or CT scan may be warranted to assess for associated ligamentous injuries or to better visualize complex fractures. Treatment strategies for radial head fractures depend on the fracture type and the patient's age, activity level, and overall health. Non-displaced fractures often benefit from conservative management including immobilization in a splint or brace, along with pain control and physical therapy once healing has commenced. For more complex or displaced fractures, surgical intervention may be necessary, which can include open reduction and internal fixation or, in cases of severe comminution or arthritic changes, radial head resection or replacement. Successful management aims to restore full range of motion and strength to the elbow joint. Complications may arise, including stiffness, chronic pain, and the potential for post-traumatic arthritis. Therefore, rehabilitation plays a key role in recovery, with an emphasis on gradual range of motion exercises and muscle strengthening to ensure optimal functional outcome. Monitoring and follow-up are essential, particularly in cases involving surgery, to assess healing and adjust rehabilitation protocols as needed. The overall prognosis for radial head fractures and dislocations generally depends on the initial injury severity, the effectiveness of treatment, and adherence to rehabilitation recommendations. With appropriate care, most patients can achieve satisfactory function and return to their pre-injury activities. However, some may experience long-term consequences, highlighting the importance of timely diagnosis and targeted intervention.
