![]() ![]() In conjunction with the distal radioulnar joint, the proximal radioulnar joint allows for pronation and supination. The radiocapitellar joint, along with the medial collateral ligament or ulnar collateral ligament, provides a significant degree of valgus stability, especially with the elbow in extension. The ulnotrochlear and radiocapitellar joints enable flexion and extension of the elbow, and allow for the transmission of forces from the forearm to the humerus. Together they form a modified hinge joint. All three are located within a single joint capsule. The elbow consists of three separate bony articulations: the radiocapitellar, ulnotrochlear, and proximal radioulnar joints. This dual blood supply likely contributes to its resistance to osteonecrosis even following displaced fractures. The radial head derives its blood supply from both intraarticular and intraosseous sources. ![]() Just distal to the head but proximal to the tuberosity is the radial neck, which is narrower than the head and slightly concave.Īrticular cartilage covers nearly the entire circumference of the radial head. The radial head also articulates with the lesser sigmoid notch of the ulna medially. It is disk-shaped with a flattened end that articulates with the capitellum of the humerus proximally. The radial head lies at the proximal end. Fractures of the radial neck occur most often in children and are much less common in adults.įunctional anatomy - The radial head and neck comprise the most proximal portion of the radius ( figure 1 and figure 2 and figure 3). Radial head fractures occur throughout adulthood the mean age at the time of injury is approximately 45 years. On average, fractures in men occur seven years earlier than in women. ![]() Some studies describe a male predominance with a ratio of 2:1, but others describe equal distribution between genders. They represent between 1.7 and 5.4 percent of all fractures in adults. (See "Elbow anatomy and radiographic diagnosis of elbow fracture in children" and "Evaluation of elbow pain in adults" and "Distal radius fractures in adults".)Įpidemiology and risk factors - Radial head and neck fractures are common and are present in about 30 percent of all elbow fractures. The management of pediatric elbow fractures and other upper extremity injuries is discussed separately. The presentation, evaluation, and basic management of radial head and neck fractures are reviewed here. Nondisplaced fractures can be managed by knowledgeable, primary care physicians orthopedic referral is needed for more complex fractures. A thorough understanding of the psychological, cultural, and biomechanical aspects of gymnastics are necessary to care for these athletes.Introduction - Radial head and neck fractures occur frequently, most often following a fall onto an outstretched hand. Overuse injuries of the elbow are common in gymnastics and include osteochondritis dissecans of the capitellum, radiocapitellar plica syndrome, and newly described radial head stress fractures. Additionally, we synthesized our clinical experience and expertise in gymnastics to provide a sport-specific rehabilitation program that can be used by providers treating surgical and nonsurgical conditions of the elbow and wishing to provide detailed activity instructions to their athletes. Beyond common diagnoses of radiocapitellar plica and osteochondritis dissecans of the capitellum, we describe a pathology unique to gymnasts involving stress fracture of the radial head. As a result, unique overuse elbow injuries are common, primarily on the lateral side of the elbow. Early specialization is the norm in this sport, and gymnastics also has the highest number of participation hours of all youth sports. Participation in gymnastics among youth athletes is high, being the sixth most common sport in children. To provide a comprehensive review of the unique overuse elbow injuries seen in youth gymnasts and to provide an up-to-date synthesis of the available literature and clinical expertise guiding treatment decisions in this population.Ī review of the PubMed database was performed to include all studies describing elbow biomechanics during gymnastics, clinical entities of the elbow in gymnasts, and outcomes of operative and/or nonoperative treatment of elbow pathology in gymnasts. Gymnastics is a unique sport that places significant loads across the growing elbow, resulting in unique overuse injuries, some of which are poorly described in the current literature. ![]()
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