Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Chapter 4
- Section I Fractures of the proximal radius
- Section II Fractures of the radial shaft
- Section III Fractures of the distal radius
- Chapter 5
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Section I - Fractures of the proximal radius
from Chapter 4
Published online by Cambridge University Press: 05 February 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Chapter 4
- Section I Fractures of the proximal radius
- Section II Fractures of the radial shaft
- Section III Fractures of the distal radius
- Chapter 5
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Summary
OPEN REDUCTION AND INTERNAL FIXATION OF RADIAL HEAD FRACTURES
Indications
Open reduction and internal fixation (ORIF) for radial head fractures is used to stabilize displaced radial head fractures (Mason Type II) (Table 4.1).
Non-displaced fractures (Mason Type I) are managed with early motion. To facilitate immediate motion aspiration of the joint fluid (haematoma) is recommended. Comminutedanddisplaced fractures(Mason Type III and IV) are best treated with complete early excision.
Pre-operative planning
Clinical assessment
Pain localized in the affected elbow.
Obliterated contour of the skin in the intracondylar recess (‘soft spot’).
Assess and document neurovascular status of the arm.
Careful examination of ligament stability is mandatory.
Radiological assessment
Anteroposterior (AP) radiograph, a lateral view and a radial head view of the affected elbow (Fig. 4.1). A CT scan is helpful to demonstrate the exact fracture geometry. In children or in unclear situations (e.g. previous injury) the contralateral side should be evaluated.
Operative treatment
Anaesthesia
Regional and/or general anaesthesia.
At induction, administer prophylactic antibiotics according to local hospital protocol (e.g. 3rd generation cephalosporin).
Table and equipment
Small-fragment instrumentation set or Herbert screw set - ensure the availability of the complete set of small compression screws.
Radiolucent armtable.
Image intensifier. Check for adequate visualization in 2 planes prior to draping.
Table set up
The instrumentation is set up on the side of the operation.
Image intensifier is fromthe front side of the armtable.
- Type
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- Information
- Practical Procedures in Orthopaedic Trauma Surgery , pp. 60 - 64Publisher: Cambridge University PressPrint publication year: 2006