Radial Head and Neck Fractures

The radius is one of the two forearm bones, and the radial head is the upper part of the radius that forms the elbow joint. The radial head is shaped like a disc and allows the forearm to rotate. When falling onto an outstretched hand, the force of the fall can travel up the forearm bones, and cause the radial head to be driven into the humerus bone, and result in a radial head or neck fracture.

Radial head and neck fractures are common and occur in 20% of acute elbow injuries. In some cases, elbow dislocations involve fractures of the radial head. Radial head fractures normally occur in people who are 30 – 40 years of age. Symptoms are swelling and pain around the elbow, particularly when rotating the forearm. Other symptoms may include the inability or difficulty to bend or straighten the elbow and rotate the forearm.

If a fracture occurs, it is usually just a crack or a small piece that breaks off. Fractures are normally classified according to the degree of displacement. Treatment depends entirely on the type of fracture as well as the classification of the fracture. The majority of these don't need surgery and can be treated in a sling. Occasionally if a large piece has broken off or if the fracture displaces and results in a step in the joint, Prof McGuire may recommend surgery to reduce and fix the broken piece. In some cases, the broken piece causes a mechanical block to the rotation of the forearm. If this occurs, then surgery will also be required. The surrounding soft tissues, such as the ligaments may also be damaged and may need to be repaired. If the damage is severe, the orthopaedic surgeon may remove the entire radial head and replace it with an artificial radial head in order to improve long-term function.