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of the Adult's Elbow > Fractures of the Radial Head What is a Fracture of the Radial Head? A fracture of the radial head is a complete or incomplete break in the radius (arm bone) occurring at its head, the disc-shaped portion of the bone closest to the elbow. A fracture of the radius affects your ability to rotate your forearm. Nondisplaced fractures do not involve separation of the fracture ends. Comminuted fractures involve the entire radial head, which separates into discrete fragments. This type of fracture involves the head of the radius, the elbow joint, and the soft tissue surrounding the fracture site, including nerves, tendons, ligaments, blood vessels, cartilage, and muscles. The kind of accident producing this injury often dislocates the elbow as well. Causes of a Fracture of the Radial Head? This injury is often the result of a fall on the outstretched hand, and is often associated with a wrist fracture. It may be the result of any accident causing a dislocation of the elbow. Risk of this type of fracture increases with:
While the accidents that cause these types of fractures often cannot be avoided, you can help prevent them by building adequate muscle strength and conditioning prior to exercise, athletic practice, or competition in contact sports. Increased muscle mass helps protect the bones and surrounding tissue. It is important to wear appropriate protective equipment during sporting activities such as football, hockey, or roller-blading. Symptoms of a Fracture of the Radial Head? With a fracture of the radial head, there will be severe pain at the site of the injury. The elbow will swell, and your ability to flex and extend the elbow will be limited. You will be unable to rotate your forearm, particularly the ability to turn the palm upwards. There may be visible deformity if the fracture is complete and the bone fragments separate enough to distort the normal contour of the arm. The arm will be tender to the touch. You may experience numbness or coldness in the lower arm and hand, a sign that the blood supply is impaired. Treatment of a Fracture of the Radial Head? As in the case of any suspected fracture, seek medical care immediately. Many tissues quickly lose their elasticity and must be promptly treated in order to assure maximum healing. Cut away clothing, if possible, but do not move the injured arm to do so. Using a triangular sling is helpful and provides comfort. Follow directions for R.I.C.E.:
You will be asked to supply details about how the injury occurred, and to provide information about previous conditions of the arm, hand, and shoulder. X-rays of the arm, including the joints above and below the primary injury site, help determine the fracture type and the extent of damage to the bone. If your elbow is dislocated this injury must be treated as well. Treatment of nondisplaced fractures may be as simple as the use of a splint or sling for 3 days, followed by limited motion within the range of your pain tolerance. Early motion is the key to a successful outcome in these cases. If there is continued pain and limited motion over time, conservative (non-surgical) treatment may not be adequate and you should return to your doctor for further evaluation. Displaced or comminuted fractures, in which the radial head has separated into bone fragments, require surgery to ensure that rotation of the forearm returns to normal after healing. When it is shattered beyond repair, the radial head is surgically removed. Appropriate analgesia is used and outpatient pain medication is prescribed. Surgical risk increases with smoking and/or the use of drugs, including mind-altering drugs, muscle relaxants, antihypertensives, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers, and corticosteroids. Rigid splints are used to immobilize the arm after surgery. Follow your doctor’s instructions, which may include using heat after 48 hours to increase blood circulation in the injured site. A heating pad or heat lamp can penetrate the splints. After the splints are removed, use an ice pack 3 or 4 times a day. Place ice cubes or chips in a plastic bag, wrap the bag in a moist towel, and place it over the injury for 20 minutes at a time. If heat feels better it can be applied instead, using a heat lamp, heating pad, hot soaks or showers, or heat liniments and ointments. Treatment with a whirlpool can also be very helpful. Acetaminophen is often recommended for mild pain. Eat highly nutritious foods, including extra protein (meat, fish, poultry, cheese, milk, legumes, tofu, eggs) and increased fiber. Your doctor will tell you when you can begin reconditioning the arm. He or she will provide you with range-of-motion exercises that help facilitate a complete recovery. Use ice massage for ten minutes before and after doing these exercises. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top of the cup so the ice protrudes, and massage firmly over the injured area in a circle about the size of a baseball. Do this for 15 minutes at a time, 3 or 4 times a day. Resume normal activities gradually after treatment, remembering that complete healing may take weeks or even months, depending on the seriousness of the injury. The average healing time for this fracture is 6 to 8 weeks in adults and 4 to 6 weeks in children. Healing is considered complete when there is no sign of motion at the fracture site and when x-rays show complete union of the bone. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |