Radial Head Fracture with Medially Displaced Fragments Excised by Two Incisions

Abstract

Introduction Radial head fractures are the most common elbow fractures and it usually presents with fracture fragments displaced outwards and forwards, medially displaced fragments are very rarely documented in the literature. We are describing a case of comminuted radial head fracture with medially displaced fragment without concomitant elbow dislocation. Case presentation A 35 year old man presented with a history of fall on outstretched hand. X-rays and CT image reconstruction was done which showed comminuted radial head fracture with two major fragments, one was on the lateral side of elbow joint and another on medial side, without concomitant elbow dislocation. Complete excision of radial head was done using two incisions, one standard Kochers incision and a separate medial incision. Elbow was immobilized for two weeks thereafter gradual range of motion exercises was started. Almost complete range of motion was regained following surgery and no heterotropic ossification was noted after two years of follow-up. Conclusion Our case did not fall in any of the two injury patterns described by El Ghawabi and was not associated with concomitant elbow dislocation. We propose comminuted radial head fracture with medially displaced fragments may present without elbow dislocation. We also recommend early institution of elbow mobilization to regain maximum elbow movements.