Radial head epiphyseal separation is often caused by a fall with the shoulder joint abducted, the elbow joint extended and everted, leading to the radial head impacting the humeral head. This injury is commonly seen in children's elbow joints.

bubble_chart Etiology

The injury mechanism and types are similar to those of a radial head fracture. Most cases are Salter-Harris type II or type I injuries. They can be classified into four types:

1. Type I: The "tilted cap" type, accounting for approximately 50%;
2. Type II: The compression type;
3. Type III: The comminuted type;
4. Type IV: The compression fracture type.

bubble_chart Diagnosis

Any patient who experiences swelling, pain, compression, and dysfunction on the lateral side of the elbow after an injury should undergo X-ray imaging for a definitive diagnosis.

bubble_chart Treatment Measures

1. Manual reduction: Most cases show good outcomes. The technique involves extending and pronating the elbow, varusing the elbow joint, and pressing the radial head to achieve reduction. After reduction, the elbow is flexed to 90° and immobilized with a gypsum cast for 3 weeks.
2. Percutaneous reduction: Suitable for "crooked hat" compression fractures with separation that fail manual reduction.
3. Open reduction: Indicated when the above methods yield unsatisfactory results. Generally, no pin fixation is required after reduction, except for old fractures where Kirschner wire internal fixation is necessary to prevent postoperative displacement.