The superior radioulnar joint forms the proximal pivot of the forearm rotation mechanism, the radial head rotating within the annular ligament and radial notch of the ulna during pronation and supination. Together with the inferior radioulnar joint it allows the full 180 degrees of forearm rotation that makes the hand so versatile. Radial head fractures at this joint are the most common elbow fracture in adults.
Radial head fractures classified by Mason are the most common elbow fracture in adults, typically from a fall on the outstretched hand. The critical assessment after radial head fracture is whether forearm rotation is blocked by a mechanical block fragment, which indicates surgical intervention. Radial head excision, arthroplasty, or fixation are guided by fracture pattern and associated injuries including the Essex-Lopresti lesion of combined radial head fracture and interosseous membrane disruption.
The most common adult elbow fracture from FOOSH mechanism, classified Mason I through IV, with blocked forearm rotation indicating surgical intervention and Essex-Lopresti lesion requiring radial head arthroplasty.
Annular ligament subluxation in children under 5 from a sudden longitudinal traction force producing a pronated held arm without bony tenderness, reduced by hyperpronation technique.
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