Documentation of associated injuries occurring with radial head fracture

Abstract

We believe a better way is needed to accurately describe the spectrum of associated injuries that commonly occur in conjunction with a radial head fracture. A review of our institution's experience with 333 radial head fractures from 1997 to 2002 documented 88 (26%) associated injuries. Based on this clinical experience, our goal was to develop an accurate and comprehensive description of associated injuries. A shorthand suffix method first recognizes the type of radial head fracture with the traditional Mason classification, followed by abbreviations designating the articular injuries, coronoid (c) and olecranon (o), and the ligamentous injuries, lateral collateral ligament (l), medial collateral ligament (m), and distal radioulnar joint (d). The proposed system offers a logical and reproducible (98%) extension of the current Mason fracture classification to document the presence of additional articular and ligamentous injuries. This provides an opportunity to standardize the communication of fracture type with further details of other injuries that ultimately can help with better understanding of treatment outcome based on the precise injury complex.

Fig. 1

The diagram illustrates an elbow injury consisting of a Mason Type III radial head fracture and dislocation, which is termed Type III lm, indicating injury to the medial (m) and lateral (l) collateral ligaments with a comminuted radial head fracture (III).

Fig. 2

A diagram illustrates a Mason Type II fracture with dislocation and coronoid fracture described as a Type II clm injury.

Fig. 3

The diagram depicts the evolution of the current classification system. The broad designation of complicated or uncomplicated is expanded to recognize the ligamentous and articular injuries that potentially may complicate any of the Mason I to III types of radial head fractures. MCL = medial collateral ligament; LCL = lateral collateral ligament; DRUJ = distal radioulnar joint.