Radial Head Fracture Info
Last reviewed
Radial head fractures — Mason classification, conservative management, and indications for fixation or replacement.
What you're feeling
You will likely feel pain right on the outside of your elbow. This pain often flares up when you try to turn your forearm, like when opening a door or using a screwdriver. Simple tasks like reaching behind your back to fasten a bra or tucking in a shirt can become very difficult. You might find it hard to lift objects or carry groceries because the joint feels unstable.
Your symptoms may feel worse at night or first thing in the morning. Many patients report that sleeping on the injured side is impossible due to the ache. The pain often returns after you use your arm for daily activities. While some fractures are stable and heal well without surgery, others cause significant discomfort that limits your movement.
If your injury involves more than just the bone, you might feel a sense of looseness or instability in your elbow. This can happen if other structures around the joint are also damaged. Your surgeon will look closely at these areas to ensure everything is repaired correctly. Without proper care, this instability can lead to poor long-term results. Most people with minor fractures find that rest and gentle movement help the pain settle over time.
What's actually happening
When you fracture the top of your forearm bone, you often damage the soft tissues that act like a gasket around your elbow joint. This injury can tear the ligaments that hold your joint together, much like a stretched rubber band losing its snap. If the bone breaks into many pieces, the stability of your entire arm is at risk, and other structures may become unstable too.
Your surgeon looks closely at how the joint is aligned to decide if it can heal on its own or needs repair. If the bone breaks into three or more pieces, your surgeon may replace the broken part with a metal implant. This metal piece acts as a new shock absorber to keep your arm moving smoothly. In many cases, patients do well with this replacement, and long-term results show that 96% of patients have satisfactory functional results.
Even if the bone heals well, you might notice some stiffness or changes in the joint over time. X-rays often show wear-and-tear arthritis in most cases after early removal of the broken bone. However, if your surgeon can fix the bone or replace it properly, you can regain good function. Most patients with complex injuries can achieve good outcomes, though some may still feel dissatisfied with their recovery.
What we can do about it
For many stable fractures, you can start with self-care and physiotherapy. Your surgeon may recommend resting the arm and using a sling for a short time. Physical therapy aims to restore your elbow's range of motion and strength. Most patients with isolated, stable fractures see excellent results with this non-surgical approach. Even fractures with small displacements of 2 to 3 mm often heal well without surgery. You should give this conservative management a fair chance before considering other steps.
If pain persists, your surgeon might discuss medical options to help you manage symptoms. While the evidence notes that local anaesthetic injections after joint aspiration do not offer extra benefit, other treatments may be used for specific issues like arthritis. For some patients with wear-and-tear arthritis following a fracture, cortisone or hyaluronic acid injections can provide relief. These injections target inflammation or lubricate the joint to reduce pain. The effect of these treatments varies, but they are often used when general function is limited by discomfort rather than the fracture itself.
Surgery is considered when conservative care reaches its limit or the bone is too broken to fix. Your surgeon may recommend replacing the broken bone with a metal implant if it cannot be reconstructed. This option is often chosen for complex fractures with more than three fragments or when ligaments are also injured. In cases of terrible triad injuries, your surgeon might choose to repair the bone if stable fixation is possible. The goal of surgery is to restore stability and function when non-surgical methods are not enough.
When to see someone
See your GP if you have persistent pain that does not improve with rest, or if you feel weakness and instability in your elbow. Ask for a specialist review if your elbow locks or gives way, or if symptoms interfere with your sleep or work. Seek help immediately if you notice a sudden worsening of symptoms. Timely diagnosis is vital to avoid complications like forearm instability. Most minor injuries found on scans do not cause symptoms, but if your pain continues, further assessment is needed to ensure the correct structures are treated.
