FRACTURE-RADIAL HEAD/NECK

Natural instinct in attempting to break a fall is placing your hand out in front of you. The force of the fall, however, could travel up your lower forearm bones and dislocate the elbow. It could also break the smaller bone (radius) in the forearm. A break can occur near the elbow at the radial “head,” “neck,” or both. Symptoms include pain on the outside of the elbow, swelling in the elbow joint, difficulty in bending or straightening the elbow, and/or inability or difficulty in rotating the forearm (palm up to palm down or vice versa). According to the degree of displacement (movement from the normal position) the decision can be made to manage the fracture with or without surgery.

It is a natural instinct to attempt to break a fall by placing your hand out in front of you. The force of the fall, however, could travel up your lower forearm bones and dislocate the elbow. This force can also break the radius, which is one of the two arms in the forearm that make up the elbow joint. A break can occur near the elbow at the radial “head,” the “neck,” or both. These injuries are very common and often times, radial head fractures accompany elbow dislocations.

Symptoms include pain on the outside of the elbow, swelling in the elbow joint, difficulty in bending or straightening the elbow, and/or inability or difficulty in rotating the forearm (palm up to palm down or vice versa).

According to the degree of displacement (movement from the normal position) the decision can be made to manage the fracture with or without surgery. Type I fractures are generally small cracks and the bone is not displaced. Since the fracture is not displaced, non-surgical treatment is usually recommended. Placing the arm in a splint or sling will immobilize the broken bone and allow the fracture to gradually heal.

Type II fractures involve a displaced bone that has moved at least 2 mm. Bony fragments may create a mechanical block to forearm rotation. Surgery is often recommended to removal small fragments of bone and to realign the fracture. Larger fragments are managed surgically with plates and screws.

Type III fractures are the most severe fractures and involve multiple bone fragments. Oftern, there are also joint damage and surrounding soft tissue injuries. These fractures must be treated surgically. Depending on the severity, the bone fragments may be repair with plates and screws or removed. Extreme cases will require the removal of the entire radial head and sometimes, implanting an artificial (metal) radial head which will improve long-term function.