![]() Viola will often use bone graft from the patient’s own (autologous) hip, leg or wrist which acts like living bone glue to fill in the fracture to ensure a better healing rate of this severe, complex fracture type. One of the other known complications of the Type III radial head fracture is non-union. ORIF (open reduction internal fixation) with a plate and several screws and autologous bone graft for this more complicated, severe fracture type. This allows the patient to start immediate motion to prevent the elbow from becoming stiff, which is a known complication of this injury. Viola reduces the fracture openly and places screws and sometimes a plate over the fracture to stabilize the fracture and lock it together. Fixation also allows for faster return to full range of motion and elbow use. If joint fractures are not fixed, the fragmented incongruent bone will eventually cause cartilage wear on the joint, which leads to pain and arthritis. ORIF (open reduction internal fixation) surgical treatment for the displaced fracture because it is in the joint and unstable. Patients are allowed to slowly increase their level of activity as the fracture proves to heal without displacement. Weekly x-rays are also performed to ensure that the fracture remains non-displaced (does not shift or further worsen) while it heals over the next six weeks. Patients are sent to Therapy to make sure they regain all of their motion. The patient can be placed in a sling or splint (absolutely no cast) for comfort for a couple of days, but then is encouraged to begin early active range of motion exercises to prevent loss of motion of the elbow and forearm. Viola will order additional x-rays and/or an MRI to evaluate these other underlying injuries. If other severe associated injuries of the soft tissues of the elbow and/or wrist are suspected, as in dislocation, ligament or capsular disruption, Dr. Type IV-fracture and complete elbow dislocation.Type III-multiple pieces of broken bone (comminution) which are displaced, mechanical block to motion, often significant damage to the elbow joint and ligaments stabilizing the elbow.Type I-small, minimally displaced fracture (2mm with no comminution, but with mechanical block and greater loss of motion.This will determine the course of treatment depending on the fracture type: Viola will order a CT Scan of the elbow to evaluate the amount of radial head fracture displacement and/or fracture comminution (fragmentation). The patient is often first seen in the Emergency Room since radial head fractures usually result from a fairly traumatic injury. Focus should also be placed on wrist pain for associated injuries. Initially, a detailed history and physical exam will be performed along with x-rays. Pain and difficulty bending and straightening the elbow and in moving the forearm palm up and palm down.Essex-Lopresti lesion: DRUJ wrist dislocation and radial head fracture.Distal radioulnar joint (DRUJ) injuries in the wrist.Terrible Triad: elbow dislocation, radial head fracture, coronoid fracture.Medial and lateral collateral ligament MCL/LCL injuries. ![]() 30% of radial head injuries have other associated injuries which can include: Radial head fractures usually occur with a fall on an outstretched hand (FOOSH) with the forearm and hand facing down (pronation) and there is an axial load across the elbow. Loss of motion is a very common complication to any elbow injury and restoring the stability of the elbow as soon as possible is essential in order to be able to begin immediate elbow motion to prevent any further loss of motion. The elbow is a very complex joint that must be managed carefully by a specialist when an injury occurs. Therefore, a joint that is strong and with limitless range of motion is essential to our daily lives. Tendons in the elbow are strong enough to withstand body weight, as in push-ups and yoga poses. They contribute to palm-up and palm-down activities of daily living and motions that allow us to work and play sports. They allow us to reach our mouth, head, feet and back. It helps the forearm rotate palm up and palm down and to stabilize the elbow.Įlbows are complex joints that are like the unsung heroes of the upper extremity. ![]() Over half of the load transfer across the elbow is through the radial head. The radial head of the elbow is a cartilage-covered rotating head located on the lateral side (outside) of the elbow. They occur more often in women than men and in people 30-40 years old. Radial head fractures are the most common fracture in the elbow.
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