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Radial Head Fracture Hand Physiotherapy
and fractures of the radial head are among the most common elbow injuries in
One in every six elbow fractures in hospital emergency departments involves
damage to the radial head (that's close to 17% occurrence rate).
Radial head fracture injuries are typically characterized by:
- Loss of strength and
- Deformity in the elbow, forearm, and wrist
head fracture may affect only the radial head and lateral side of the elbow. Or
it may involve a complex injury pattern that affects other parts of the upper
extremity, including the humerus, forearm, hands, and wrists.
fractures will require proper and prompt treatment to retain healthy joint function
and prevent permanent disability.
Failing to do so can lead to
- elbow nerve
- trauma-induced arthritis
- and similar complications
treatments include both open and closed methods and require hand therapy and elbow physiotherapy for
In this blog, we take
an in-depth look at fractures of the radial head and what causes them. We also
discuss the common symptoms and other injuries associated with radial fractures
and explore the treatment options you should know about.
What Are the Fractures of the Radial Head?
head is an articular surface near the proximal end or the central part of the
Basically, it is the crown of the radius, which, along with the
humerus, constitute the two main bones in your forearm. The radius runs from
the elbow joint to the outer side of the wrist, ending just where the thumb is
Any crack that develops in the radius right beneath the elbow is
referred to as a fracture of the radial head.
fractures are usually classified into three main types, depending on the
distance by which the bones have been displaced. The extent of displacement dictates
the treatment plan and types of physical therapy required for recovery.
Type I Fracture
when the radius is displaced by less than 2 mm.
There might be just a split in
the bone, and it may not have moved from its normal position at all. Type I
fractures can be quite hard to diagnose initially as small cracks may not be
visible on x-ray images. They generally become more prominent and show up on
scans performed 2-3 weeks after the injury.
During this time, people usually
experience pain in the elbow movement.
Performing any strenuous activities with
a type I radial fracture can shift the bones significantly and worsen the
Type II Fracture
radius is displaced by more than 2 mm, it is referred to as type II fracture.
II fractures generally affect a large part of the bone and may hinder specific
movements, such as forearm and wrist rotation. Patients may recover after
wearing a sling or brace for 1 to 2 weeks, followed by mobility exercises.
depending on the damage caused, minor surgery may be required to remove small
pieces of the broken bone, especially if they obstruct joint function.
large bone fragment has moved out of its regular place, a metal plate and
screws may be necessary to join it back.
Type III Fracture
Type III fractures
are the most severe kind of radial head injuries.
They produce multiple bone
splinters that can make bone restoration almost impossible. In most cases, the
damage extends to the ligaments, nerves, and other structures surrounding the
Type III fractures typically call for major surgery.
may either remove the broken fragments altogether or, if possible, try to fix
it by putting them back together. If the removal of the radial head is
necessary, an artificial unit may be installed in its place.
This is a
permanent treatment and can restore a degree of movement, ensuring long-term joint
What Causes Fractures of the Radial Head?
cases, there is a history of falling on an outstretched hand.
In senior people,
radial head fractures may be caused by certain orthopedic conditions, such as
rheumatoid arthritis and osteoporosis.
In younger patients
presenting with radial head fractures, the injury usually stems from direct
trauma to the joint. For example, athletic activities and motor vehicle
accidents can result in damage to the radius and the radial head.
Symptoms of Radial Head Fractures
common symptoms of this type of elbow injury include:
- Joint ache
- Numbness or tingling sensation
- Skin discoloration and swelling on the outer side
of the elbow
- Intense pain while straightening or flexing the
- Difficulty or inability to rotate the forearm
(e.g., turning hand from palm down to palm up and vice versa)
fracture their radial head typically experience elbow pain and swelling soon
after the fall or injury. If the bones are displaced, there may be an obvious
deformity with the pointy edge of the elbow sticking out at an odd angle.
develop type I radial head fractures may only experience minor discomfort at
However, with the passage of time, it can progress into more severe
- limited joint movement
- bruising and
Other Conditions Similar to Radial Head Fractures
hardly any conditions that are similar to a fractured radial head.
distinct type of injury that can be diagnosed with radiography tests or a
clinical examination that assesses the biomechanics of the upper extremity.
individuals suffering from a radial head fracture tend to develop other elbow
conditions or nerve conditions with this injury. This particularly happens when
the fracture goes undetected due to minor bone displacement.
that can develop following the fractures of the radial head include:
- Posterior interosseous neuropathy
- Radiocapitellar arthrosis (posttraumatic joint
- Annular ligament disruption
- Lateral ulnar collateral ligament (LUCL) tear
- Medial (ulnar) collateral ligament (MCL) strain/
Who Is at Risk of Developing Fractures of the Radial Head?
at risk of fracturing their radial head, especially when they try to break a
fall with their hands. Of course, it’s only an instinctive motion. But it
shifts your entire weight onto the elbow and forearm muscles.
The impact of the
fall can easily force the radius to move farther back into the joint,
dislocating the radial head in the process.
women above 40 years of age are also prone to fracturing the radial head. This
is mostly due to the fact that bones naturally become weak and fragile with
age. Therefore, even a seemingly minor strain on the forearm can increase their
chances of experiencing radial head dislocation.
and other people who frequently partake in sports activities are also at a high
risk of fracturing their radial head.
construction workers and people with known medical conditions, such as
osteochondritis and Panner’s disease, are also susceptible to radial head
Treatment for Fractures of the Radial Head
Radial head fractures are serious injuries that can have life-long
consequences if not treated on time. If you think you may have fractured
your radial head, seek medical help at your local hospital or emergency
Individuals with a fractured or dislocated
radial head are generally advised not to perform activities with the
Until your injury is assessed by a medical practitioner,
it’s better to avoid daily activities, such as hot showers, which can
increase the rate of blood flow in the body, which in turn,
will increase pain and swelling.
Your doctor may take an x-ray scan to
identify the degree of bone damage and displacement. Initial management
focuses on stabilizing the fracture so that the bones can set and heal
Whether your arm is placed in a cast directly or you need
to undergo surgery to set the bones in their regular position,
our senior physiotherapists and hand therapists will definitely be needed to restore joint function and
strength before you can resume full activities.
How Physiotherapy Can Help People with a Fractured Radial Head
goal of physiotherapy following a radial head fracture or dislocation is to
improve the range of motion of the affected arm. It also helps reduce the pain
and swelling and is especially useful for improving recovery after surgery.
initial treatment at a hospital, individuals can come to us for physical
therapy for healing a fractured radial head.
master-level physiotherapists perform a thorough examination to determine which
plan and mobility exercises will be best suited to each individual.
for radial head fractures involves a progressive series of exercises. They are
specially designed to promote natural bone restoration and gradually improve
the range of motion of your injured arm. At times, other therapies might also
be used in combination to ensure efficient and effective recovery.
Some of the
therapeutic modalities we commonly use for fractured radial head rehab include:
Fractures of the
radial head usually heal without complications within 6 to 8 weeks after the
bone stabilization. Some individuals are able to resume lighter activities
within 2 to 3 weeks as well.
The key is to seek medical help immediately and
comply with the physical therapy plan so you can quickly get back to doing what
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Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
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Commonly treated hand pain injuries includes
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At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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