Radial head fracture
Radial head fracture is very common injury in young adults. When you sustain a injury on elbow or fall on out stretch hand you may have radial head fracture.
Symptoms (what you feel)
- You feel pain on lateral aspect of elbow joint
- Your pain increase on rotational movement of forearm
- You may feel something clicking (crepitus) in your elbow joint
Diagnosis
Physical examination (what your doctor feel)
Your doctor will check your elbow for swelling and tenderness — comparing your injured elbow to your normal elbow. He may also move your elbow into a variety of positions to assess range of motion and overall function of the joint and to do can some specific test for various ligaments injuries if you feel comfortable without much pain.
Often the diagnosis can be made on the basis of the physical examination, but you need investigations to rule out other causes and to determine the severity of the injury. These investigations may include:
- X-rays- X-rays may be needed to confirm radial head fracture and to rule out other bone fractures. In x-ray your doctor can see the various parameter of fractures to decide treatment. However, X-rays don’t show soft tissues, such as ligaments and tendons.but there may be some sign in the X-ray which can tell your doctor about ligaments injury.
- CT Scan- Elbow joint is very complicated joint so in elbow joint injury if your doctor suspect some other fracture also or your elbow fracture includes more bones and intraarticular fractures then your clinician advise for CT Scan with 3D reconstruction to understand your fracture pattern more clearly and to plan surgical exposure and fixation.
- Magnetic resonance imaging (MRI)- Isolated radial head fracture seldom require MRI but when your doctor suspect some ligaments injuries he may advise MRI scan. MRI can show the extent of a ligament injury and signs of damage to other tissues in the elbow, including the cartilage
Treatment
First-aid care can reduce pain and swelling to your elbow.
There is no need of plaster support in undisplaced fracture of radial head and simple pouch arm sling or shoulder immobiliser is sufficient. If fracture is displaced or you are feeling much pain then your orthopaedic doctor will advise you for a plaster support to reduce pain and swelling. if pain is intolerable then you can take anti-inflammatory and analgesic.
Nonsurgical treatment (Plaster support and early mobilization)
Treatment for a radial head fracture mostly non surgical. if your radial head fracture is undisplaced and your pain is tolerable then your doctor advise you for a pouch arm sling or shoulder immobilizer for 2 to 3 weeks and some analgesics and when you feel no pain or very little pain your orthopaedic doctor will start mobilisation of your elbow joint either by home based physiotherapy or by a physiotherapist. if you have slight more pain but fracture is undisplaced then your orthopaedic doctor may advise you for a plaster support for 2 to 3weeks. A physical therapist will teach you how to do exercises that you will perform either with continued supervision or at home.
The goal of physiotherapy is to reduce pain and swelling, restore your elbow’s full range of motion, and strengthen muscles.
This course of physical therapy successfully treat a undisplaced radial head fracture
Radial head fracture fixation (Surgery)
Your doctor may recommend surgery if:
-
- You have displaced radial head fracture
- Your radial head fracture is communited (crushed radial head)
- Your radial head fractured in more then 2 or three pieces
- Your fractured part of radial head is more angulated
- Your radial head fracture is associated with other fractures
In surgical fixation of radial head fracture orthopaedic surgeon uses mini-plates and various type of headless mini screw so it will not impinge on joint movement.
Dr. Anil sharma has good experience of radial head fracture fixation surgery. He always try to save radial head even it is three part fracture. He saved radial head of 10yrs old child. His surgical exposure technique and fixation technique is very good so there is no problem of hardware prominence or impingement. He operated many case of radial head fixation but he has not a single case of radial head fracture fixation failure or complications