Radial neck fracture

Last revised by Mostafa Elfeky on 7 Aug 2023

Radial neck fractures are, together with the radial head fractures, relatively common injuries, especially in adults, although they can be occult on radiographs. 

Radial neck fractures are almost always the result of a fall onto an outstretched hand. Force applied along the radius results in impaction of the radial head against the capitellum. The result is often a radial head or neck fracture. The neck fractures may be complete or incomplete.

The elbow is typically radiographed in AP and lateral projections, although an oblique view is very frequently also obtained to better visualize the radial head (see elbow radiography).

The images generally show the loss of the mild concave curvature of the anterior cortex of the base of the radial head creating an abrupt offset between the radial head and neck 1.

An elbow joint effusion is usually present, however, it could be absent on plain x-ray in some cases as part of the radial neck is extra-articular. 

Radial neck fractures are usually not displaced. As a result, they are usually treated with immobilization in cast. In the rare situation where there is a transverse fracture of the neck and displacement of the proximal fracture fragment, operative intervention may be required.

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