Radial Head Fracture
Other popular names
Who does it affect?
Children and adults.
What is it?
The radial head is often injured as a result of a fall onto the hand. This may be as a result of sports or a simple fall. The injury is most often seen in adults and may also be seen in children. A significant force is needed to break the bone in young healthy adults.
A radial head fracture will typically cause pain in the elbow which is made worse by elbow movement. There may be bruising around the elbow most often on the outer side. Rotating the hand from a palm up to a palm down position may be particularly difficult and painful. The elbow often feels stiff and swollen. In some cases the elbow joint may be dislocated resulting in severe pain and deformity of the elbow.
The diagnosis of radial head fracture is made from the history of how the injury occurred and by examining the elbow joint. If I suspect a radial head fracture, I will confirm this with an x-ray.
The best treatment for a radial head fracture depends on a number of factors including your age, your occupation, the findings from examining the elbow, any other associated injuries, how the bone has broken and how far the parts of the bone have moved out of position. I will advise you about the treatment options for your particular injury. In most cases of the fracture has not moved significantly out of position and if you can rotate the forearm then the injury can be treated in a "collar and cuff" sling for comfort and with pain killers as necessary. The fracture will typically take six weeks to heal but many people find that they can move the elbow without pain before this time.
In more severe cases I may offer you the option of surgery.
Surgery is carried out under general anaesthetic and takes about 20-40 minutes.
The exact procedure undertaken depends on the exact injury to the radial head. Fixing the fracture, removing the radial head or radial head replacement may be carried out.
You can go home soon after the operation. The anaesthetic will wear off after approximately 6 hours. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off. The arm should be elevated as much as possible for the first 5 days to prevent the hand and fingers swelling. Gently bend and straighten the fingers and elbow from day 1. The dressing will be removed soon after your operation. The wound is cleaned and redressed with a simple dressing. Avoid forced gripping or lifting heavy objects for 2-3 weeks. The sutures are removed at about 12 days. You should notice an improvement in symptoms within a few weeks but the final result may take some 3-6 months.
Return to normal routine
Keep the wound dry until the stitches are out at 12 days.
Return to driving:
The hand needs to have full control of the steering wheel and left hand the gear stick. You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed.
Return to work:
Everyone has different work environments. Returning to heavy manual labour should be prevented for approximately 4 - 6 weeks. Early return to heavy work may cause the tendons and nerve to scar into the released ligament. You will be given advice on your own particular situation.
Overall over 95% are happy with the result. However complications can occur.
General risks (less than 1% each):
- Neuroma (nerve pain)
Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any elbow surgery from a minor procedure to a complex reconstruction).
- This depends on the exact operation carried out. I will advise you of the before surgery is undertaken as part of the informed consent process.