From the Guidelines
The most common lateral elbow fracture is a radial head fracture, accounting for 50% of cases in adults. This type of fracture typically occurs when a person falls onto an outstretched hand, forcing the radial head against the capitellum of the humerus 1. The diagnosis of a radial head fracture can be made using conventional radiographs, which are often the first-imaging modality used to exclude a fracture or dislocation.
- Key characteristics of radial head fractures include:
- Accounting for 50% of cases in adults
- Often occurring due to falls onto an outstretched hand
- Typically identified on conventional radiography
- May be associated with elbow joint effusion, which can imply an occult elbow fracture Management of radial head fractures depends on the severity, with non-displaced fractures typically treated conservatively and more severe fractures requiring surgical intervention 1.
- Treatment options include:
- Conservative management with immobilization and early range of motion exercises for non-displaced fractures
- Surgical intervention, including open reduction and internal fixation or radial head replacement, for more severe fractures
- Pain control using NSAIDs, such as ibuprofen or naproxen, for 1-2 weeks
- Physical therapy to restore function, typically starting 1-2 weeks after injury with gentle active and passive range of motion exercises.
From the Research
Common Lateral Elbow Fractures
- Radial head fractures are the most common fractures occurring around the elbow, accounting for one-third of elbow fractures 2
- These fractures can occur in isolation, but are often associated with other injuries, such as ligamentous, cartilaginous, or other fractures 3, 4
- The characteristics of the radial head fracture, including fragment number, displacement, impaction, and bone quality, influence the treatment technique used to optimize the outcome 3
Treatment Options
- Undisplaced or minimally displaced fractures can be treated non-operatively with early active range of motion (ROM) 3, 4
- Displaced fractures can be treated with open reduction internal fixation (ORIF), radial head excision, or prosthetic replacement, depending on the severity of the fracture and associated injuries 5, 3, 4
- Radial head arthroplasty may be preferred over tenuous fracture fixation in the setting of associated ligament injuries when maintenance of joint stability could be compromised by ineffective fracture fixation 3, 2
Diagnostic Tools
- Plain radiograph is the optimum method to diagnose a radial head fracture 6
- CT scan is a helpful diagnostic tool and should be used if available to evaluate the fracture and associated injuries 4