Indications

• Non-displaced and minimally displaced radial head fractures can be treated with a sling or splint followed by early motion exercises of the elbow to prevent stiffness.

• Partial (Mason type II) fractures of the radial head are amenable to operative fixation.

• Fractures involving the entire radial head (Mason type III or IV) are best treated with excision and eventually prosthetic replacement.

Clinical assessment

• Tenderness over the radial head.

• Assess and document neurovascular status.

• Careful examination of ligament stability, including the wrist and forearm, is mandatory to rule out elbow dislocations and Essex-Lopresti lesions.

Radiological assessment

• Plain radiographs taken in orthogonal planes with the addition of oblique views (Fig. 5.1.1).

• CT is helpful to assess the exact fracture geometry. In children or in unclear situations (e.g. previous injury), the contralateral side should be evaluated.

Preoperative consent

• Obtain informed consent from the patient, including but not limited to risks, beneits, alternatives, complications and potential outcome.

Operative treatment

• The World Health Organization (WHO) Surgical Safety Checklist should be used in the operating room.