Quantitative Three-Dimensional Computerized Tomography Measurement of Radial Head Fractures

Author(s): Guitton TG, Werf HJ, Ring

Source: J Shoulder Elbow Surg 19: 973-77, 2010.

​This is a retrospective analysis of 46 patients with radial head fractures studied by computerized tomography.  Using quantitative three-dimensional CT scans, the authors attempt to define a stable versus unstable fractures.  The authors found that partial radial head fractures  were usually multi-fragmented. For example,  73% often had small fragments by volume and surface area criteria.  In addition, they found of the fractures which involved the entire radial head only 25% met the criteria of having greater than 3 fragments.  They also found of those patients with three or fewer fragments, 70% had very small fragments associated. 
This article points out the difficulty of defining radial head fracture anatomy on plain radiographs.  It also highlights the complexities of fixing the radial head, particularly Mason 2 fractures which appear to have relatively large fracture fragments on plain films, but are commonly more complex and difficult to repair.