Radial Head Fractures

The notes on this page are written as a source of information to both patients and health professionals. It is a general overview and its content should not be seen as direct medical advice. Further information regarding diagnosis and treatment specific to your condition can be made via a consultation with Dr Amaranath.

Anatomy

The radius is one of two bones in the forearm (the other being the ulna). The radial head is the most proximal part of the radius and articulates with the capitulum (distal part of the humerus). Together the radial head, distal humerus and olecranon (name for proximal part of ulna) make up the elbow joint.

The radial head had three primary functions:

  1. Forearm rotation

  2. Valgus (lateral) stability of the elbow

  3. Transfers force from the wrist joint across the elbow joint (longitudinal stability)

What types of radial head fractures are there? 

Radial head Fracture Dr Jeevaka Amaranath Sydney Orthopaedic Surgeon

Radial head fractures can be classified based on the number of fracture fragments, the displacement and whether the elbow is stable (see terrible triad injuries of the elbow).

What are the common causes? 

Commonly, it is a traumatic injury following a fall onto an outstretched arm where the force is transmitted from the wrist joint to the radial head.  

What are the preferred Investigations/Imaging?

  1. Plain X-Ray of the Elbow & Radial head specific view (Coyle’s view) - This should include an Anterior/Posterior and Lateral views of the elbow. The Coyle’s view is an oblique view which emphasises the radial head and should always be performed if a radial head fracture is suspected.

  2. CT scan of the Elbow - This is commonly used to further quantify and accurately diagnose the fracture of the radial head.

What are the treatment options?

  1. Non-operative

    This treatment may be reserved for undisplaced and stable fractures of the radial head. Patients are initially placed in a sling for comfort during the first week and commenced on a specific rehabilitation programme to maintain range of motion to the elbow and also allow the fracture to heal.

  2. Radial Head Fixation or Replacement

When there is significant displacement of the radial head fragments, a block to forearm rotation or instability of the elbow, operative fixation using screws (Fig 1) or replacement of the radial head (Fig 2) will be recommended. In patients who have multiple fracture fragments which may not be reconstructable with screw or plate fixation, a radial head replacement may be offered as the alternative.

What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after upper limb surgery please see our Rehabilitation Protocols here.