Radial head Fracture
Side view of the elbow joint, showing a broken radial head
Several different fractures can occur around the elbow. The most common fracture involves the radius bone where it meets the elbow joint. Depending on the exact location, it is called a radial head or neck fracture.
Causes
Radial head and neck fractures usually occur following a fall onto an outstretched hand. The sudden impact transmits energy up the forearm, resulting in a fracture of the radial head or neck near the elbow joint.
Diagnosis
Radial head and neck fractures result in pain, bruising, swelling, and decreased motion. Patients usually have difficulty bending or straightening the elbow, and difficulty rotating the forearm.
X-rays are essential for diagnosis of any elbow fracture. This degree of displacement, or shift of the fracture, can help to decide the best treatment option.
Treatment
Non-surgical treatment
Non-displaced or minimally-displaced fractures, where the bone is still well aligned are most common. These are typically treated non-surgically. Motion is started in the first several days to prevent stiffness.
Surgery
Some radial head or neck fractures are treated surgically. A displaced fracture may not heal at all, or may heal in a poorly aligned position. Both of these scenarios can produce pain and limit normal elbow motion. When surgically treated, the fracture pieces are lined up and held together with one of more metal screws.
Patient 1: Radial head open reduction internal fixation (ORIF). The two pieces are lined up, and held in place with a metal screw.
Patient 2: Radial head ORIF with compression screw. Injury x-ray on the left, post-surgery x-ray on the right.
Two patient examples of radial fractures treated successfully with a metal screw are shown in the images above. This technique aligns the fracture fragments, and allows for early motion of the elbow, which maximizes the chance for a pain free and normal elbow motion.
Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.