The radius is one of the bones in the forearm and the radial head forms part of the elbow joint. A fracture of the radial head usually results from a fall on the outstretched hand. The injury may result from falls whilst playing sports, cycling or vehicular accidents. Radial head fractures are sometimes associated with elbow dislocations. 

Radial Head 2

How is a radial head fracture diagnosed?

Fractures of the radial head may be suspected from the mechanism of injury resulting in pain, deformity and bruising over the outer aspect of the elbow. The diagnosis is confirmed on X-rays of the elbow. In some instances a CT scan may be arranged to study the fracture in greater detail and help plan surgical treatment.

How is a radial head fracture treated?

Non-operative treatment

The initial treatment will consist of supporting the arm in a sling, the use of oral pain medication and advice on protection of the elbow. Whilst your arm is in a sling you will be advised to keep the fingers, wrist and shoulder moving to prevent stiffness. As the pain in the elbow settles, you will be encouraged to start gradually moving the elbow. If the fracture is minimally displaced and the movements of the elbow are not impeded, this treatment is continued until the fracture has healed.

Surgical treatment

In cases where the fracture is displaced or fragmented or if the fracture is associated with a dislocation of the elbow, the fracture may be treated with an operation. The exact nature of the operation will depend on the location and pattern of the fracture.

Operative fixation: This is the preferred method of treatment in selected displaced fractures of the radial head where rotational movements are impeded. It consists of realigning the fragments of bone to restore the shape of the bone and then fixing the fragments with metal devices such as screws with or without a plate; the metal devices hold the position of the fragments until the fracture has healed. The fracture will usually heal over a period of 3 to 6 months.

Radial head replacement: Fractures of the radial head that are severely fragmented may not be amenable to repair. These fractures may be treated with radial head replacement.

Radial head excision: Severely fragmented fractures of the radial head that are not associated with a ligament injury may be treated by surgical removal of the bone fragments. This treatment may be considered for individuals who place limited demands on the elbow.

How long does it take to recover from a radial head fracture?

Recovery will depend to some extent on the severity of the fracture, any associated ligament injuries and the type of treatment. Pain usually starts easing within a couple of weeks. You may start using the hand and elbow, as the arm gets comfortable. Office duties may be resumed within 2-3 weeks. Strenuous task should be avoided until the fracture has healed over a period of 3-6 months.

1. Displaced, multifragmentary fracture of the radial head
Rotation of the displaced, multifragmentary fracture