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ORIF Radial Head Fracture

intermediate Level

Primary Indication

Displaced Mason II-III radial head fractures with mechanical block

Danger Structures

  • undefined (Variable - depends on specific approach and fracture pattern) - Deep to surgical field

Visual Atlas

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Step-by-Step Technique

1

Incision from lateral epicondyle to radial neck

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Skin necrosis from excessive tension
  • Damage to underlying structures
2

Develop interval between anconeus and ECU

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
3

Supinate forearm to move PIN away from surgical field

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
4

Incise capsule and annular ligament

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
5

Inspect fracture and assess reparability

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
6

3+ fragments with >50% involvement - consider replacement

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
7

Reduce articular fragments

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
8

Provisional K-wire fixation

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
9

Headless compression screws (2.0mm) for large fragments

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Malposition of hardware
  • Damage to adjacent structures
10

Mini-fragment plate in safe zone for complex patterns

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Malposition of hardware
  • Damage to adjacent structures
11

Safe zone: 110° arc with forearm in neutral rotation

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
12

Check elbow ROM and PRUJ stability

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
13

Repair annular ligament if possible

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
14

Perform intraoperative imaging/fluoroscopy to confirm adequate position and alignment

Surgeon's Tip
EXAM KEY: Documentation of intraoperative findings is crucial for ORIF Radial Head Fracture.
Danger Zone
  • Radiation exposure
  • Inadequate imaging
15

Irrigate wound thoroughly and achieve meticulous hemostasis

Surgeon's Tip
EXAM KEY: Copious irrigation reduces infection risk. Bipolar for hemostasis near neurovascular structures.
Danger Zone
  • Hematoma formation
  • Wound complications