The elbow is a complex joint formed by a trio of bones in your arm: the radius and the ulna in your forearm and the humerus in your upper arm. The part of the radius bone nearest to the elbow, called the radial head, can fracture after an injury from any sort of basic fall, during which you instinctively reach out with your arm to break the fall.
After evaluating the break with an x-ray and, if necessary, a computed tomography (CT) scan and a magnetic resonance image (MRI), your physician will recommend one of three courses of action:
No surgery. This is the most commonly recommended option, because radial head fractures are often “clean” and don’t affect elbow alignment very much. If there is no dislocation and little damage to the surrounding soft tissue, treatment usually involves two to three weeks in a splint or sling, followed by coming to OSR for several months of range-of-motion and strengthening exercises with our physical therapy staff. Often, an elbow brace is utilized as well as the exercises.
Open reduction and internal fixation surgery. Here, the break is severe enough that the now-misaligned pieces cause range-of-motion difficulties that will only worsen. This restorative surgery involves using small screws or pins to restore the radial head.
Radial head replacement. If the radial head is so severely damaged that repair is not possible, the surgeon will remove the damaged radial head and may replace it with a metal implant. In either surgical approach, the surgeon will repair surrounding ligaments as necessary.
After radial head surgery, you must rest for several days, keeping your elbow in a splint and your arm elevated to heart level. Here at Oahu Spine & Rehab in Kailua we will recommend range-of-motion exercises for your shoulder and fingers to be performed during these days. Then you will move on to a rehabilitation period for the elbow itself, which can last for months. Range-of-motion exercises come first; strengthening work occurs much later, usually beginning about six weeks after surgery.
With our phases of care, our integrated health center will be able to create a program for you as assigned by our medical team. This can include anything from chiropractic care, acupuncture, physical therapy and modalities in order to get your radial head back to fully functioning.
Whether you need radial head surgery or not, we can design a customized rehabilitation program for you. Resuming your sports activities or daily functions free of stiffness and pain will enable you to return to normal life after this sort of injury.
