Treatment of Radial Head Fracture with 1mm Displacement
A radial head fracture with 1mm displacement should be treated conservatively with a removable splint and immediate active finger motion exercises, avoiding immobilization beyond 3 weeks. 1
Conservative Management Protocol
For minimally displaced radial head fractures (<2mm displacement), non-operative treatment is the standard of care. 1, 2 Your patient with 1mm displacement falls well within this category and does not require surgical intervention.
Immobilization Strategy
- Use a removable splint rather than rigid casting for approximately 3 weeks 1, 3
- The splint must never obstruct full finger range of motion at any point during treatment 1
- Avoid prolonged immobilization beyond 3 weeks, as extended immobilization significantly increases stiffness risk 1
Immediate Rehabilitation Requirements
- Initiate active finger motion exercises immediately following diagnosis to prevent stiffness, which is one of the most functionally disabling complications 1, 3
- Finger motion does not adversely affect adequately stabilized fractures in terms of reduction or healing 3
- Active finger exercises through complete range of motion should begin at the first encounter 4
Follow-Up and Monitoring
- Obtain radiographic follow-up at approximately 3 weeks to confirm adequate healing 3, 5
- Obtain additional imaging at the time of immobilization removal 3
- Reevaluate any patient with unremitting pain during follow-up, as this may indicate complications requiring intervention 4, 1
Critical Pitfalls to Avoid
- Never immobilize for extended periods (>3 weeks), as complications occur in approximately 14.7% of cases with prolonged immobilization 1, 3
- Do not allow splints to restrict finger motion, as hand stiffness can be very difficult to treat after fracture healing and may require multiple therapy visits or additional surgical intervention 4
- Do not miss associated injuries—obtain true lateral radiographs to assess alignment and rule out DRUJ instability or other elbow injuries 1
When Surgical Intervention Would Be Indicated
While not applicable to your 1mm displaced fracture, surgical management becomes necessary when: 3, 2
- Displacement exceeds 2-3mm 2, 3
- Dorsal tilt >10° 3
- Intra-articular displacement is present 3
- Associated elbow or forearm instability exists 6
Expected Outcomes
Long-term studies demonstrate that non-operative treatment of minimally displaced radial head fractures (2-5mm) results in predominantly favorable outcomes, with most patients having no subjective complaints at long-term follow-up 7. Your patient with only 1mm displacement should expect excellent results with conservative management.