Radial Head Fractures
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How Does a Radial Head Fracture Happen?
A radial head fracture of the elbow typically occurs with a fall with arms outstretched. The force of the fall travels up the forearm to the elbow. You could sustain an elbow dislocation with this type of fall or a fracture to a bone in the forearm called the radius. Most commonly the area of the fracture is at the radial head.
Radial head fractures account for about 20% of elbow injuries, are more frequent in women than men. They are more likely to happen around the ages of 30-40 years old.
The fracture occurs at the proximal area of the radius where it meets the elbow.
Anatomy of the Elbow Bones
The elbow has 3 bones.
- Humerus
- Ulna
- Radius
The radius is in the forearm, next to the ulna.
How do You Diagnose a Radial Head Fracture?
Radial head fractures are diagnosed with an X-ray in most cases.
Symptoms of a Radial Head Fracture
Symptoms of a Radial Head Fracture include:
- Pain on the outside of the elbow
- Swelling around the elbow
- Difficulty and pain with trying to straighten or bend the elbow
- Pain when trying to turn you palm up or down
Treatment for A Radial Head Fracture
Treatment for this injury depends on the severity of the fracture. Doctors use a classification system depending on the degree of displacement of the fracture (how far the bones are away from the normal position).
Physician Examining a Patient’s Elbow
Type 1 Radial Head Fractures
Type I fractures are generally small cracks where the pieces remain in place. The fracture may not immediately be visible on an x-ray but may show up after about 3 weeks after the injury on the x-ray. Treatment for this may involve using an elbow splint or a sling for a few days with early movement recommended. An occupational therapist/physical therapist can help maintain elbow range of motion with stretches and exercises that focus on bending and straightening the elbow.
Type 2 Radial Head Fractures
Type II fractures are slightly displaced and may involve a larger piece of the bone. If displacement is minimal treatment may involve wearing an elbow splint or a sling for 1-2 weeks then start on elbow, forearm and wrist range of motion exercises.
If the fragments are large and out of place, you may need surgery by an orthopedic surgeon who will attempt to hold the bones together with screws or a plate and screws. At times the broken pieces may have to be removed from the radial head.
Type 3 Radial Head Fractures
Type III fractures have multiple broken pieces of bone that cannot be placed back together with screws or plates. This type of fracture also creates damage to the surrounding elbow structures including ligaments that support the elbow joint.
Surgery would be required to fix or remove the broken pieces and repair the soft tissue damage. At times they need to remove the whole radial head depending on your surgeon either thy will remove the radial head only or at time the radial head is replaced with a artificial radial head. Depending on the severely of your fracture and what was done in surgery you may be placed in an elbow splint for a period of time.
Treatment for this type of fracture may involve going to Occupational or Physical Therapy for range of motion exercises for your elbow, forearm and at times your wrist. Lifting and weight bearing through the arm are restricted for up to 6 to 12 weeks depending on what was needed to be done in surgery.
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