The forearm is made up of 2 bones, radius and ulna. A break or fracture in the long bone radius is known as radial head fracture. The radial head is located below the elbow joint. Athletes commonly suffer from such fractures. The common cause of such fractures is a fall on outstretched hands putting undue stress on radius and radial head. When this stress increases to a point where the bone cannot bear the pressure, then a break or fracture occurs. Athletes commonly suffer from such fractures occurring around elbow, although other individuals can also have a radial head fracture due to direct trauma or in combination with other injuries such as a sprain, wrist or elbow dislocations and fractures of other bones like the ulna or humerus. Usually, these fractures are not displaced, i.e. there is a break in the bone, but the bone fragment is not detached from the bone. Such fractures are easily treatable and heal faster and most of the times do not require surgery.
Radial head fracture usually is not obvious on x-ray. They can be seen after healing has started. Radial head fracture commonly occurs with elbow dislocations. About 10% of elbow dislocations involve a radial head fracture. For non-displaced fractures, mobilization with a cast or splinting is done. Surgery is required for displaced fractures.
Symptoms of Radial Head Fracture
- Immediate and acute pain at the elbow and the forearm.
- Swelling may be present.
- Bruising may be present.
- Pain upon movements.
- Difficulty and pain upon weight bearing.
- Patient has difficulty in performing movements such as bending or straightening the elbow and rotating the arm.
- In case of severe and displaced radial head fracture, the elbow may appear crooked in shape.
- Numbness and tingling may be present.
Causes of Radial Head Fracture
- Falling onto an outstretched arm.
- Forceful weight bearing on the elbow.
- Direct trauma or injury to the elbow.
Treatment of Radial Head Fracture
Treatment depends on the severity of the fracture, whether it is displaced or not.
- In case of a grade 1 fracture which has no displacement, immobilization along with splint is sufficient for healing. After healing, mobility exercises can be started.
- Soft tissue massage helps in promoting the healing process.
- Electrotherapy treatment such as ultrasound can also be done.
- NSAIDs such as ibuprofen and naproxen can be given for pain relief.
- In case of a displaced fracture, surgery may be required to fix the bone fragments back in place using plates or screws.
- If the bone has fractured into multiple fragments, then these fragments may be removed altogether.
- Rest should be taken from aggravating activities.
- After the healing, patient should return to activities gradually.
- After the fracture has healed, patient should start a rehab program comprising of stretching and strengthening exercises to regain mobility, flexibility and range of motion of the elbow and arm.