Question

30 year-old female with elbow pain following a fall. What's the diagnosis? (bonus points if you name the fracture with an associated radio-ulnar joint dislocation)

Answer

Radial Head Fracture           

       

• Typically secondary to fall on an outstretched hand; head of radius collides axially with capitulum of humerus
• Most common type of adult elbow fracture; radial neck fractures more common in children; 
• Must be on the lookout for the Essex-Lopresti fracture (bonus answer)
  • Radial head fracture + dislocation of the radio-ulnar joint (typically disruption of interosseous membrane
  • Repair early (typically ORIF) otherwise there may be loss of forearm extension, pronation, and supination
  • Look for distal radio-ulnar tenderness / instability by grabbing distal radius and ulnar and moving in opposite directions (see video below)

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References

http://www.wheelessonline.com/ortho/radial_head_frx

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