Management of Radial Head Dislocation

Initial Diagnostic Confirmation

• Obtain CT without contrast if radiographs show abnormal radiocapitellar alignment to fully characterize the injury pattern, identify associated fractures, and assess for the "terrible triad" constellation, as recommended by the American College of Radiology 1, 2
• Look specifically for coronoid process fractures on CT imaging, as these injuries indicate severe instability and are commonly missed on plain radiographs, according to the American College of Radiology 2
• Assess for joint effusion on lateral radiographs, which may indicate occult fractures even when the dislocation appears isolated, as suggested by the American College of Radiology and Praxis Medical Insights 2, 3

Postoperative Management

• Initiate active finger motion exercises immediately to prevent hand stiffness, which is a functionally disabling complication, as recommended by the American Academy of Orthopaedic Surgeons 4, 5

Critical Pitfalls to Avoid

• Do not miss coronoid fractures, as they indicate severe instability and require CT imaging for identification, according to the American College of Radiology 2