Aims: The purpose of this study was to evaluate the incidence of combined osseous and ligamentous injuries by MRI in patients admitted with displaced or comminuted radial head fractures. Methods: A retrospective study was undertaken on twenty-four consecutive patients with an acute radial head fracture (Mason type II & III) without documented dislocation or tenderness at the distal radioulnar joint (DRUJ). The evaluation was done with elbow antero-posterior and lateral x-ray images and MRI images performed with the patient in a splint in sagittal, coronal, axial, axial oblique and coronal oblique planes. We investigated the integrity of both medial and lateral collateral ligaments, the presence of capitellar osteochondral defects or bone bruises and loose bodies. Results: The MRI evaluation of the participants in this study revealed the presence of a high percentage of ligamentous injuries. The incidence of associated injuries was: medial collateral ligament not intact: 13/24 (54.16%), lateral collateral ligament not intact: 18/24 (80.1%), both collateral ligaments not intact: 12/24 (50%), capitellar osteochondral defects 7/24 (52.4%), capitellar bone bruises 23/24 (95.83%) and loose bodies 22/24 (91.67%). Conclusions: High level of suspicion should be employed when treating displaced or comminuted radial fractures because concurrent osseous and/or ligamentous injuries might be present This speciþc type of injury with the broad range of presentation and accompanying injuries tests the clinician and makes the treatment challenging.