Radial head fracture

Case contributed by Dr Antonio Rodrigues de Aguiar Neto

Presentation

This patient reports trauma to the elbow due to a fall while riding a bike two days ago.

Patient Data

Age: 50 years
Gender: Male

The elbow's AP and lateral radiographs reveal a slightly displaced radial head fracture, with posterior and more marked anterior fat pad elevation (the sail sign) indicative of elbow joint effusion.

CT of the elbow reveals a displaced intra-articular fracture of the radial head, with more than 2 mm articular step off. There are two fracture lines, a vertical fracture line extending through the radial head's articular surface and an associated horizontal fracture line, representing comminution and favoring Mason type 3 fracture.

No supracondylar humeral fracture. It preserved unotrochlear articulation. 

Impression: The findings are consistent with a Mason type 3 fracture.

Case Discussion

A common type of elbow injury in adults is radial head fracture 1-4. The Mason classification distinguishes radial heard fracture into four groups: (type 1 = undisplaced; type 2 displaced; type 3 comminuted; type 4 associated with the elbow joint's dislocation 1-4. Early detection and appropriate radial head fracture classification are critical for ensuring their appropriate treatment 1-4.

This case illustrates radial head fracture, type 3, Mason classification, which usually requires surgical treatment.

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