Radial Head Fracture

Non-displaced, closed, radial head fracture with raised anterior and posterior fat pads (Sail sign)

Non-displaced, closed, radial head fracture with raised anterior and posterior fat pads (Sail sign)

The Sail Sign

  • The sail sign on an elbow x-ray describes the elevation of the anterior fat pad to create a silhouette similar to a billowing spinnaker sail from a boat. It indicates the presence of an elbow joint effusion.
  • The anterior fat pad is usually concealed or seen parallel to the humeral line.  When there is a joint effusion, the anterior fat pad becomes elevated.
  • Elevation of the anterior fat pad usually indicates the presence of an intra-articular fracture. In adults, this is usually a radial head fracture whereas in children, the commonest cause of a raised elbow fat pad is a supracondylar fracture. 
As you can see, the raised fat pads look like the ships sail on the x-ray

Treatment

Radial head fractures are managed conservatively as they heal well without intervention.

  • Analgesia
  • Polysling in a position comfortable for the patient
  • Virtual fracture clinic referral
  • If elderly with poor mobility, please consider referral to REACT prior to discharge

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