Intra-articular radial head fracture in the skeletally immature patient: progressive radial head subluxation and rapid radiocapitellar degeneration

Nathan L Van Zeeland, Donald S Bae, Charles A Goldfarb
Journal of Pediatric Orthopedics 2011, 31 (2): 124-9

BACKGROUND: Intra-articular fractures of the radial head in skeletally immature patients are rare. Most studies in the literature group intra-articular radial head fractures with the more common extra-articular, metaphyseal fractures of the radial neck; considered as a group, outcomes are favorable. In this study, we specifically evaluate a group of skeletally immature patients with intra-articular radial head fractures, and a rapid progression of posterior subluxation of the radial head with the development of joint arthrosis.

METHODS: A chart review identified 7 patients who were referred for management of an intra-articular radial head fracture that had failed initial nonoperative management. All the elbows progressed to posterior radiocapitellar subluxation and joint degeneration within 4 months after initial injury. We cataloged clinical, radiographic, and intraoperative findings.

RESULTS: The average age at the time of injury was 10 years and 6 months (range, 8 to 13 y). Five patients were male and 2 were female. Five patients had Salter-Harris III fractures of the radial epiphysis, while 2 had Salter-Harris IV injuries. The radiocapitellar articulation was reduced on the initial injury films, but all the elbows showed progressive radiocapitellar subluxation and arthrosis, whereas the ulnohumeral articulation remained unaffected. Motion was decreased in all patients with an average arc of extension-flexion of 38 degrees to 127 degrees and an average arc of rotation of 84 degrees. Six patients underwent salvage surgery.

CONCLUSIONS: Skeletally immature patients with an intra-articular radial head fracture are at risk for progressive radial head subluxation and radiocapitellar arthrosis.

LEVEL OF EVIDENCE: Retrospective Case Series, Level IV.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.