Description
In this lecture, Lee Van Rensburg discusses the management of radial head fractures. He acknowledges his prior consultancy with Acumed but notes he has not worked on their radial heads specifically. The talk begins with a review of historical classifications of radial head fractures including the Mason, Hotchkiss, and Mason-Mayo classifications, which categorize fractures based on displacement and fixability. Rensburg emphasizes the shift in surgical techniques and implant technology over the decades, highlighting the importance of examining collateral ligament integrity alongside radial head fractures, particularly in complex injuries like the terrible triad.
He discusses the treatment options available, including fixation, replacement, and excision, detailing the circumstances under which each might be employed. Rensburg references recent studies that suggest an increasing preference for fixation over excision, as well as the evolving understanding of radial head fractures in the context of associated soft tissue injuries. He illustrates case examples that highlight the complexity of decisions faced in treating these injuries, particularly the role of the coronoid and other structures in determining the best course of action.
With respect to surgical techniques, he provides insights into various approaches used for accessing the radial head, stressing the importance of avoiding complications such as overstuffing the radial head during reconstruction. He concludes by advocating for a comprehensive approach to treatment that accounts for the entire elbow injury, recommending revision only when clearly indicated and emphasizing the need for careful assessment of ligamentous injuries.