Fractures of the Head of the Radius with Medial Displacement
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It is now well recognised that fractures of the head of the radius are not trivial injuries, but are due to the elbow joint being subjected to a considerable degree of violence. The injury usually occurs when the patient falls on to the outstretched hand and the head of the radius is driven violently against the capitellum, which acts rather like a blunt chisel and either impacts the radial head or else splinters off a portion of it. The capitellum itself often suffers a considerable degree of damage to its articular cartilage, although this does not usually show on routine X-rays. Unless the crack in the head of the radius is of a very trivial nature, operation should be advised in order to excise the radial head. This should not be delayed for more than a few days, and I have found that the best results are obtained if the operation can be performed within a few hours of the injury. Attempts have been made to replace the radial head with plastic or metal inserts, but I do not consider that this procedure is' advisable and that experimental surgery of this nature should be left to large clinics, where the problem can be properly evaluated.