Radial head fracture
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A large joint effusion is present (anterior fat-pad is elevated) an intra-articular fracture through the radial head with a 1 mm step/gap is noted. There is slight dorsal angulation of the radial head.
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Radial head fractures are usually managed non-operatively (sling, ROM limited by range) with operative management required for comminuted fractures or ones with a large intra-articular step.