The radial head is the circular proximal end of the radius that articulates with the capitellum of the humerus and rotates within the radial notch of the ulna during forearm pronation and supination. It is the most commonly fractured bone in adult elbow injuries, typically from a fall on the outstretched hand that drives the radial head against the capitellum.
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| Ossification | The radial head ossification centre appears at age 5 and fuses with the radial shaft at skeletal maturity. It is the last of the six elbow ossification centres (CRITOE: Capitellum, Radial head, Internal epicondyle, Trochlea, Olecranon, External epicondyle) to appear. |
Mason classification of radial head fractures guides treatment: Type I (non-displaced), conservative, Type II (displaced partial), fixation if blocking rotation, Type III (comminuted), arthroplasty rather than fixation, Type IV (with elbow dislocation), arthroplasty or fixation plus ligament repair. The Essex-Lopresti lesion combines radial head fracture with interosseous membrane disruption and DRUJ dislocation. Radial head arthroplasty rather than excision is mandatory to prevent longitudinal forearm instability and proximal radius migration.
Find the lateral epicondyle and slide about 2 cm down the outer side of the forearm into a small dip. Place your thumb there and slowly turn the person's palm up and down: the rounded radial head rotates under your thumb. It sits in the soft spot formed by the lateral epicondyle, the radial head and the olecranon.
The most common adult elbow fracture, from a fall onto an outstretched hand, causing lateral elbow pain and limited rotation.
In toddlers, a sudden pull on the arm slips the annular ligament over the radial head; it is reduced by supination and flexion.
A radial head fracture with tearing of the interosseous membrane and distal radioulnar joint disruption, allowing the radius to migrate proximally.
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