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Fracture of the head of the radius: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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Symptoms of a radial head fracture
Pain and limitation of function indicate damage to the elbow joint.
Diagnosis of radial head fracture
Anamnesis
The anamnesis indicates trauma.
Inspection and physical examination
On external examination, swelling is detected along the anterolateral surface of the joint. Pressure on the head of the radius is painful. A positive axial load symptom is noted. Movements in the elbow joint are sharply limited, especially rotation and extension.
Laboratory and instrumental studies
X-rays reveal a fracture, determine its nature and the displacement of the fragments.
[ Treatment of radial head fracture
Indications for hospitalization
Patients with compression fractures of the head and neck of the radius, as well as fractures without displacement of fragments, are treated on an outpatient basis in a polyclinic or under the supervision of a family doctor.
Patients with displaced fractures and comminuted fractures are hospitalized.
Conservative treatment of radial head fracture
Patients with compression fractures of the head and neck of the radius, as well as fractures without displacement of fragments, are treated conservatively. After anesthesia, the fracture site is extended to an angle of 150 °, the forearm is placed in a position between supination and pronation, and flexed at an angle of 90-100 °. The limb is fixed with a plaster cast from the upper third of the shoulder to the heads of the metacarpal bones for 2-3 weeks. During immobilization, UHF, static and dynamic exercise therapy are prescribed. After removing the plaster cast, they begin to develop movements in the joint, use thermal and pain-relieving procedures, exercise therapy. In order to avoid ossification of paraarticular tissues and the development of persistent contractures, direct massage of the joint and forced violent movements should not be performed. Mud therapy, especially at high temperatures, is equally inappropriate.
If marginal fractures are detected or the head has split into two or three large fragments located next to each other, a closed manual reposition is performed. Its technique consists of traction of the supinated limb to the longitudinal axis and deviation of the forearm to the ulnar side. Lowering the radius through the annular ligament can bring together the longitudinally split fragments. By deviating the forearm inward, the joint space is widened, eliminating pressure on the heads of the humeral condyle. The surgeon completes the reposition by pressing his fingers directly on the head of the radius. The limb is immobilized with a plaster cast in a functionally advantageous position from the upper third of the shoulder to the heads of the metacarpal bones for 4-5 weeks.
Surgical treatment of radial head fracture
In case of multi-fragmentary fractures or unsuccessful reposition, surgical treatment is used. It consists of resection of the head of the radial bone. This operation cannot be performed on children, since removal of the growth zone will lead to uneven length of the forearm bones and valgus deformity of the elbow joint.
After the operation, the limb is fixed with a plaster splint for 2 weeks and removable immobilization is used for another 2 weeks. Physiotherapy is performed to prevent adhesions and heterotopic ossification.