Radial Head Fracture

The human forearm has 2 long bones, the radius and the ulna. These bones allow the elbow and wrist to move. When a person falls on an outstretched arm, the force travels along the radius from the wrist to the elbow. At the elbow, the end of the radius (the radial head) may break. Common symptoms include pain and stiffness in the elbow.

In addition, joint swelling, limited motion, and tenderness may occur. This is worsened when the arm is straightened or rotated palm-side up. Tenderness over the outside of the elbow, below the joint over the radial head, may occur. Movement may cause a clicking sensation or pain.

This condition is usually caused by a fall on the outstretched arm. The risk of a radial head fracture is greatest in a person who has a disease that limits motion of the elbow or forearm, such as arthritis. Osteoporosis, or thinning of the bones, also increases the risks for fractures.

Precautions should be taken to prevent falls. A diet rich in calcium and regular weight-bearing exercise can help to build strong bones.

Diagnosis is based on a history of elbow pain after a fall. Physical exam and joint x-rays confirm the diagnosis.

There are no risks to others.

Initial treatment involves first aid using RICE (rest, ice, compression with bandage and/or splint, and elevation). After diagnosis by physical exam and x-rays, most radial head fractures are treated simply with an arm sling. This simple technique usually results in complete recovery in about 6 weeks.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (i.e. Advil, Motrin) or naproxen (Naprosyn, Aleve, Anaprox, Naprelan) can help reduce swelling and pain. For complex or unusually severe radial head fractures, surgery may be necessary. Surgery may involve repair of the radial head, removal of a mashed bone, and sometimes replacement with a metal or plastic spacer.

NSAIDs may have adverse effects on the stomach, kidneys, or liver.

Physical therapy may help in regaining motion and strength after injury or operation. If surgery is necessary, infection is always possible. After the fracture heals, there may be limitation of motion of the elbow and forearm. Also, arthritis of the elbow joint, weakness, or pain may result. A healthcare professional will watch for progress in restoring range of motion and strength