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Radial Head Fractures
Posted: Jun 24 2016 #(C2616)
A

Radial Head Fracture in 32F

HPI

Fall from height (ladder) with immediate onset of pain and limited function

PMH

Otherwise a healthy individual

PE

Limited and painful supination and pronation and limited flexion and extension of the elbow. Tenderness at radial head and elbow.

Poll
1 of 6
1. What is your Mason classification of this injury?
Type I
26%
540/2068
Type II
67%
1394/2068
Type III
6%
125/2068
Type IV
0%
9/2068
2. How would you treat this fracture?
Short period immobilization followed by early ROM
44%
860/1934
ORIF
53%
1034/1934
Fragment excision (partial excision)
0%
15/1934
Radial head resection
0%
10/1934
Radial head replacement
0%
15/1934
3. If you chose ORIF, what type of fixation would you perform?
K wire
9%
171/1804
Lag screw(s) only (Herbert screw)
78%
1415/1804
ORIF with Plate
12%
218/1804
4. If you choose surgical treatment, what approach would you use?
Kaplan direct lateral approach
33%
564/1696
Kocher posterolateral approach
55%
945/1696
Anterolateral Approach
11%
187/1696
5. On exam this patient has a mechanical block to pronation/supination. Would you do an aspiration of joint hematoma and injection of local anesthesia to aid in evaluation of mechanical block?
Yes
51%
901/1745
No
48%
844/1745
6. If you choose a short period immobilization followed by early ROM, how long would you immobilize the fracture for?
1-3 days
12%
222/1758
4-7 days
27%
488/1758
7-11 days
34%
602/1758
11-21 days
25%
446/1758
PROCEDURE #1

ORIF through the kocher approach with thin single k-wire

icon
OUTCOMES
Post-procedure P1
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