The radial head is the bumpy bit at the top of the radius bone where it meets the elbow. Your radius is one of the bones of your forearm, used to move your wrist and arm. Around a fifth of all acute elbow injuries are radial head fractures; it is one of the most common of all acute elbow injuries, particularly among women. If you dislocate your elbow, you may also fracture your radial head.
How do radial head fractures occur?
Radial head fractures are so common because they are often the result of putting out your hand to break a fall. Unfortunately, the force of falling onto your outstretched hand can send shockwaves up the bones of your forearm which can lead to a dislocated elbow and/or a radial head fracture.
Symptoms of a radial head fracture
Typical signs that you may have fractured the radial head of your elbow include pain or swelling on the outside of the elbow and problems bending or straightening the joint. You may be unable to twist your forearm, turning your palms up or down.
Diagnosing a radial head fracture
You will undergo a physical examination and an X-ray to determine whether you have fractured your radial head and, if so, how badly. There are three grades of fracture, depending on how far the bones have been pushed out of alignment and how many bone fragments there are.
- Type 1 fractures are small cracks, with the pieces of bone still in their original position. This type of fracture is not always visible on initial X-rays but may show up if the X-ray is taken around three weeks after the injury.
- Type 2 fractures are where the bones have been slightly displaced and there may be small fragments of broken bone within the joint.
- Type 3 fractures are the most severe radial head fractures involving many different pieces of broken bone which cannot be returned to their original position. This type of fracture may be accompanied by extensive damage to the joint and surrounding soft tissues.
Treating a radial head fracture
Treatment will be determined by whether you have a type 1, 2 or 3 fracture. With a type 1 fracture, generally you won’t require surgery. You may need to wear a splint or sling to keep the elbow immobile for a few days before gradually increasing the amount of movement. Don’t try and do too much too soon or you could move the bones out of alignment, resulting in a more serious injury.
With type 2 fractures where there is minimal displacement of the bone, you will need to wear a splint or sling for a few weeks. If there are small fragments of loose bone within the elbow joint, these will need to be surgically removed to prevent them from interfering with normal movement of the elbow, which may cause long-term problems. Larger pieces of bone may be fixed in place with a plate or screws and soft tissues may need to be repaired.
For the most severe radial head fractures, surgery is essential to repair or remove the pieces of broken bone and correct any soft tissue damage. In some cases, the entire radial head may need to be removed and replaced with an artificial radial head. After surgery, you will need to avoid lifting anything heavier than a few pounds for up to 12 weeks. You may also need to wear a splint. A physiotherapist will recommend exercises to improve elbow strength and prevent stiffness.
Recovering from a radial head fracture
It is common to experience some loss of function in the elbow following a fracture. If you have a severe fracture, you may require follow-up surgery to remove scar tissue that may be restricting movement. It is important to follow the exercises recommended by a physiotherapist as these will help you to build up strength and movement in the affected joint. You should aim to do the exercises every two to three hours or as often as recommended by the physiotherapist. It is normal to experience some pain while exercising but this should not be severe and your elbow should not feel hot or inflamed or become very swollen after exercising. Talk to your physiotherapist or specialist orthopaedic consultant if this occurs.
Thames Shoulder and Elbow specialise in the diagnosis and treatment of all types of shoulder and elbow problems. Contact us for advice about radial head fractures or any other type of shoulder or elbow injury.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
Email: admin@thamesshoulderandelbow.co.uk
Our Locations
Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Medical Centre, Chiswick – Directions
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