![]() Most complex injuries have been associated with lateral and medial ligaments injuries and interosseous membrane (Essex Lopresti). When there is a doubt as to the size and displacement of the fragment, it is useful to test with a local anesthetic injection to determine if it causes mechanical blockages, which indicates the need for surgical treatment. The medial aspect of the elbow (LCI), the interosseous membrane, and the distal ulnar radius joint should be evaluated, especially in complex cases. ![]() Suspecting possible associated lesions is important. ![]() In incomplete or nondisplaced fractures, it is necessary to investigate painful spots and the presence of small petechiae. Moreover, it is involved in longitudinal stability. The radial head stabilizes in valgus when the internal ligament complex is injured, and it does not take part when being harmless (secondary stabilizer). The physiologic elbow range of movement is zero to 150 degrees of flexion and extension, and 85 degrees of pronation, and 75 degrees of supination. They are closely related to the lateral ligament complex, mainly the annular ligament and radial collateral ligament. The head and neck are not collinear with the diaphysis and complete a 15-degree offset angle. It has a 40-degree central cavity, and it is oval-size-like. Cartilage covers the radial head except for the anterolateral third that lacks subchondral bone, and it is easily fractured. A 180-degree arch in the pronation and supination is allowed by the articulation of the proximal end of the radius with the distal humerus (capitulum), and with the ulna in the lesser sigmoid cup (trochoid joint).
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