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14 Cards in this Set
- Front
- Back
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Desribe the Indirect MOA of an acute radial head/neck injury. |
This is the most common, usually from a fall onto an outstretched hand with axial load transmission through the proximal radius with trauma against the capitellum |
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Describe a direct MOA for radial neck/head fx |
This is uncommon because of the overlying soft tissue mass |
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Describe chronic radial head/neck fractures |
Repetive stress injuries may occur, most commonly from over-head throwing |
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What is the clinical evaulation of a radial neck/head fx look like? |
1. pt typically presents with lateral swelling of the elbow, with pain exacerbated by ROM, especially supination and pronation 2. Crepitus may be elivited on supination and pronation 3. In a young child, the primary complaint may be wrist pain; pressure over the proximal raidus may accentuate the referred wrist pain. |
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What might be seen on xray with a radial neck/head fx |
1. a positive supinator fat pad sign may be present
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What is the O'Brien classification? |
Based on the degree of angulation fo the radial head/neck fx Type I: <30 degrees Type II: 30 to 60 degrees Type III: > 60 degrees |
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What is the WIlkins classification? |
Radial head and neck fx's based on the MOI -Valgus injuries caused by a fall onto an outstretched hand (compression) -Angular deformity of the head is usually seen
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LIst the valgus type injuries of the radial head/neck. |
Wilkins Type A: SHI or II physeal injury Type B: SH III or IV intra-articular injury Type C: Fx line completely within the metaphysis
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What is the tx for O'Brien type I? |
simple immobilization accomplished with with the use of a collar or cuff, a posterior splint, or LAC for 7-10 days with early ROM
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what is the tx for O'Brien Type II? Describe Patterson technique for reduction. |
Manipulated closed reduction 1. Distal traction with the elbow in extension and the forearm in supination: varus stress applied to overcome ulnar deviation of the distal fragment and open up the lateral aspect of the joint allowing for disengagement of the fragments for manipulation |
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what is the Israeli technique? |
Reduction for radial neck or head fx -Elbow in flexion, and the practitioner's thumb is used to apply pressure over the radial head while the forearm is forcved into a pronated position. |
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WHat type of cast should be used for radial head/neck fractures? |
LAC with elbow flexed to 90 degrees and forearm in pronation |
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what are the predictors for favorable outcome with a radial head/neck fracture?> |
1. <10 years old 2. isolated injury 3. minimal soft tissue injury 4. good fracture reduction 5. < 30 degree initial angulation 6. < 3mm initial displacement 7. closed reduction 8. early treatment |
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what are the complications that can occur following a radial head/neck fracture? |
1. Decreased ROM 2. radial head overgrowth 3. premature physeal closure 4. osteonecrosis of the radial head 5. neurologic 6. radioulnar synostosis 7. myositis ossificans
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