Fractures of the Radial Head: Excision, fixation or ...

[Pages:49]Fractures of the Radial Head: Excision, fixation or replacement?

Andreas Panagopoulos, MD, PhD Assistant Professor

Patras University Hospital

Objectives

? Anatomy and biomechanics ? Epidemiology & classification ? Complex patterns of injury ? Treatment algorithm ? Long term outcomes

Overview

Historically, the radial head was believed to be expendable.

..... is universally appreciated as a vital elbow structure for forearm and elbow stability

Anatomy

Anatomy

Lateral

Medial

Stability

Ulnohumeral articulation

Radiohumeral articulation

AMCL

FLEXOR tendons

EXTENSOR tendons

ULCL

Epidemiology

2-5% of all fractures 33% of elbow fractures 15-20% involve the neck 50% is associated with another injury

10% of RH associated with elbow dislocation

Biomechanics

? Force transmission

- 60% of load applied to hand

? Stability ? 30% resistance to valgus stress ? Secondary stabilizer in MCL deficiency

? Rotational motion of the forearm

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