Radial Head Fracture

Overview

A radial head fracture refers to a broken bone near the elbow. The radius is the bone that runs from your elbow to your wrist and the radial head is situated at the top of the radius, just below your elbow.  A radial head fracture most often occurs when a person tries to break a fall with their outstretched hands.

The force of the fall can travel up your forearm and dislocate your elbow or break the radius. Breaks in the radius often occur in the radial head. In fact, these fractures make up about 20 percent of all acute elbow injuries. Radial head fractures occur more frequently in women than in men and are more likely to occur between 30 and 40 years of age.

Radius On The Skeleton

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Symptoms of a Radial Head Fracture

People with radial head injuries often report elbow pain after suffering an injury. They may experience pain on the outside of the elbow, bruising or swelling in the elbow joint and difficulty in bending or straightening the elbow. It may also be challenging to turn the forearm from palm up to palm down.

Diagnosis

Doctors will order x-rays to confirm the injury and classify it as a Mason Type 1, 2, or 3 fracture. A Mason 1 break is a hairline crack in which the broken bone fragment doesn’t move. In a Mason 2 fracture, the bone fragment moves out of position by more than two millimeters. A Mason 3 classification means there are multiple breaks in the radius.

Radial head fracture is often accompanied by other injuries. Doctors will, therefore, check the stability of the ligaments in the elbow to make sure it is not dislocated and check the wrist for breaks.

Radius X-ray

Source: ericksonhandsurgery.com

Treatment

The aim is to prevent pain and stiffness in the long term. Radial head fractures don’t need to be stabilized with a plaster cast. A Mason Type 1 fracture will probably just require a splint or sling to support the arm, elbow, and forearm for two to three weeks. Over 90 percent of people with small fractures regain full function in the elbow even if it never fully straightens out.

If the crack is a bit bigger but the broken fragment is less than a third of the radial head, a sling will likely still be enough to promote healing. Surgery is only necessary for small breaks a bone fragment is in a position which blocks the elbow from its normal range of motion. A Mason Type 2 injury can sometimes require surgery.

Radial Head Fracture

Source: boneschool.com

Severe breaks may require the attention of an orthopedic surgeon. Sometimes surgery is required to insert pins or plates to hold bones in place, repair torn ligaments or insert metal to replace a broken piece of bone. Pins help to stabilize to the broken bone so that physical therapy can begin on the elbow without fear of making the injury worse. In the case of multiple breaks, the pieces of bone may be too small to put back together so the entire radial head is removed in some instances. This is often replaced with metal except in the case of elderly people or other patients who are unlikely to move a lot.

Recovery

Patients who undergo surgery report good to excellent results. In about 80 percent of cases, normal elbow function returns with a nearly normal range of motion.

Most cases of radial head fracture heal within six to eight weeks. While some broken bones require you to immobilize the injury area, this does not apply to radial head fractures. Instead, you should move the arm normally as soon as possible. This will help to alleviate stiff joints and tight muscles.  Moving will not cause further damage. As soon as you can, you should remove your sling and get moving. Exercise should include your shoulder, wrists, and fingers since these may also feel stiff. However, you should not lift heavy objects or try to bear lots of weight. This can cause stress on the joint.