Radial head fractures have a misleading name — it’s a common elbow injury, not a head injury. There are a few different radial head fracture types with various causes and ways to treat this injury.
Anatomy of the Elbow
Between your upper arm and forearm is a group of important joints that comprise your elbow. Your radial head is shaped like a disk and lets you move your forearms in a palms-up to a palms-down position and straighten your arm and elbow out. It is key to many arm movements. Around the elbow joints are a collection of ligaments that support your elbow and keep it from flopping around. A ligament is a piece of connective tissue that connects bones together. Many muscles are connected to the bones around your elbow joint, but the thicker portions of the muscle don’t cover the actual elbow. So, your elbow isn’t well protected and is at risk for injuries like radial head fractures.
What Is a Radial Head Fracture?
What is a radial head fracture? In most cases, this fracture happens due to falling onto outstretched hands. For example, if you fall off monkey bars, skates, or a scooter or if you take a hard hit in a contact sport like lacrosse, hockey, or football you could get a proximal radius fracture.
The name for this fracture comes from the portion of bone near the elbow where it usually happens: the radial head. It can also affect the radius, a smaller bone in your forearm. A radial head fracture happens in around 20% of elbow injuries and also in many elbow dislocations. They’re most common in women and in people between the ages of 30 and 40.
What Are the Symptoms of a Radial Head Fracture?
You’ll probably have the following radial head fracture symptoms in case of a broken elbow:
- Pain in the outer part of your elbow
- Swelling at the elbow joint
- Inability to bend or straighten the elbow due to pain
- Difficulty twisting your forearm to turn your palm up or down
How to Treat a Radial Head Fracture?
Radial head fracture treatment depends on the kind of fracture that you have. There are a few similar systems used to classify radial head fractures, but the original system used to differentiate between the injuries is called the Mason classification. It outlines three different fractures that are grouped by the degree to which the bones are out of their normal position:
- Type I fracture. Type I fractures usually have a subtle crack with the bone pieces staying fitted together. You probably won’t need surgery. Instead, you’ll likely use a sling or splint for a few days before slowly starting to use your elbow and wrist again. Don’t push yourself, especially if there is still a lot of pain. Trying to do too much too quickly could cause shifting and displacement of bones.
- Type II fracture. Type II fractures are a little more displaced than Type I, and they affect a larger piece of the bone. Depending on how severe the displacement is, you may or may not need surgery. Non-surgical treatment includes sporting a splint or sling for a couple of weeks before attempting exercises to increase your range of motion. If the fracture is large or out of place, you may need to see an orthopedic surgeon. If small pieces of the radial head have broken off, they’ll need to be removed. So, they don’t affect your elbow in the long term. The surgeon may try using screws or a plate with screws to hold the affected bones together. Additionally, they’ll fix any accompanying soft-tissue injuries like a torn ligament.
- Type III fracture. Type III fractures are composed of many bone pieces that can’t be put together. In these, there’ll probably be serious damage to your elbow joint and its surrounding ligaments. You’ll need surgery to take broken pieces of bone out and correct soft-tissue damage. If it’s really severe, your surgeon might remove the whole radial head and insert an artificial one so that you can maintain functionality. After surgery, for 6–12 weeks, you should avoid putting any weight on the arm, even lifting things that weigh more than a few pounds. You might have a cast or a splint for a little while after the surgery. You’ll have limited functionality in your elbow for a period of time regardless of how severe your fracture is. You should follow your healthcare provider’s instructions for exercises to help get full movement and strength back. If you do this and your elbow is still very stiff, you might need another surgery simply to remove scar tissue from the area.
Radial head fracture recovery time can range from 3–6 weeks after your initial injury, but it’s typical to have minor symptoms like discomfort or aches even after the recovery period, especially as you return to activities that you stopped due to your injury.
Long-Term Radial Head Care
From a long-term perspective, you may have pain, stiffness, and even arthritis even if your surgery and recovery go well. It’s possible that you won’t be able to completely straighten or bend your elbow like before. Even so, you should be able to carry on with your normal activities with little to no discomfort.
There are certain influences that can negatively affect your healing, like:
- Smoking. This slows down healing and affects tissues.
- Your health. Certain conditions, like diabetes, and your health behavior, like what you eat and how often you exercise, can speed up or slow down your recovery.
- Medications. If you’re already on certain medications or if you take anti-inflammatory medicine, your fracture could heal slower. Speak with your healthcare provider to better understand this part of your recovery.
After any break or injury to a joint, arthritis can appear. Arthritis or stiffness can cause occasional or continual pain. In some extreme cases, the elbow develops extra bone while recovering from a radial head fracture which limits elbow motion. Stay in close contact with your healthcare provider even after your injury has healed to ensure that nothing out of the ordinary happens.