Radial head fractures of the elbow

Break in the upper part of the radius which is one of the two bones in your forearm is radial head fracture.  This fracture happens when you try to break your own fall by stretching your hands in front of you.  Your hand and wrist hits the ground first and the shock caused in the fall would reverberate and break the head of the radius resulting in the dislocation of the elbow. If you are lucky only dislocation of your elbow will occur.  But in most cases the head of your radius  breaks. In radial fracture the head of the radius is usually not just cracking but it breaks off.   Radial head fractures are common in adults. Depending upon the severity of the fracture different treatment options are available in orthopedics.

Radial Head Fracture Diagram

What are the symptoms of radial head fractures of the elbow?

The main symptom of radial head fracture is pain. On dislocation the elbow joint swells and gets bruised. You find difficulty in straightening the hand and in turning of the hand. Lifting the palm from a palm down position to a palm up position will cause severe pain.

How is radial head fracture of the elbow diagnosed?

Diagnosis of radial head fracture is easily done by physicians by understanding the circumstances in which the fracture was caused and by studying the inability of the patient to move hands as suggested by him. X-rays will clearly show the fracture in the film and if necessary the doctor may go for other imaging techniques also to collect further details of the damages caused to the tendon and tissues in the elbow joint.

What are the surgical and non-surgical treatments for radial head fractures of the elbow?

Treatment for radial fractures is based on many factors including the type of the fracture, age and occupation of the patient etc. Treatment options based on the type of the fracture are discussed below.

Type I fracture

In type I fracture only cracks will be there. The fractured bone remains intact without any dislocations. Such fractures may be visible only in X-rays. If they are not visible in initial X-rays, they may become visible in X-rays taken after two or three weeks. Immobilization and supporting the fractured bone with sling, splint or brace will be enough for the fractured bone to heal. Attempting for too much movement may cause the bone shaft to get displaced.

Type II fracture

In type II fractures bigger breaks and displacement of the bones will be there.  In such cases the broken fragments of bone are surgically removed and brace or splint is provided for support. Systematic exercise to improve the range of motions will have to be practiced.  If the fracture is severe the surgeon will try to hold the bones together with the help of screws, plates etc. If this is not possible the surgeon will remove the broken parts of the bone and bone grafting will be done for replacing the removed bone. If any torn ligament or tendons are there correction for these will also be attempted.

Type III fracture

Type III fractures are the severest fractures in which radial head will be severely damaged.  The surgeon will find it very difficult to put the fractured pieced in position. In this type of fracture there will be significant joint damage affecting the cartilage and ligaments surrounding the bone.  This type of fracture can be treated through surgical procedures only. In this surgery the fragmented pieces of bone are first removed and necessary corrections are made to the damaged cartilage and ligaments. Bone grafting is accomplished if necessary. In severe cases cased the entire radial head will be removed and a prosthesis made of synthetic material will be substituted in place of the damaged original.

The outcome of a radial fracture surgery is very much depended on the severity of the fracture and how the injury has been treated. It will take about three month’s time for the elbow to return to its original condition. Stiffness in elbow may be felt in some cases. This can be reduced by systematic exercise and physiotherapy. The possibility of developing arthritis is an after effect of the radial head fracture.

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