Do I need surgery for a radial head fracture?

Many do not. Stable, minimally displaced fractures are treated with brief support and early motion. Surgery is for fractures that are displaced and block forearm rotation, or that come with instability, in which case the bone is fixed with small implants or, if too fragmented, replaced.

Why start moving it so soon?

The elbow stiffens faster than almost any other joint when it is held still. For stable radial head fractures, beginning gentle motion within the first week, once it is safe, is the best protection against a permanently stiff elbow.

What else is checked besides the fracture?

Because the radial head is an important stabilizer, Dr. Lee checks the elbow for ligament injuries and instability and looks at the forearm and wrist. A radial head fracture can be part of a larger injury, and recognizing that changes the treatment.

Radial Head Fracture, Steven J. Lee, MD

The radial head is part of the elbow joint on the thumb side, and it helps the forearm rotate and the elbow stay stable. It is the most commonly fractured bone in the adult elbow, almost always from a fall onto an outstretched hand.

Radial head fractures are graded by how displaced and fragmented they are. Just as important is what comes with them, because these fractures can accompany elbow dislocations, ligament injuries, or, less commonly, a forearm injury that destabilizes the wrist. A careful look for associated injuries shapes the treatment.

Why associated injuries matter

An isolated, non-displaced radial head fracture is a very different injury than one that comes with a dislocation or ligament tear. The radial head is a key stabilizer, so when it is fractured as part of a larger injury, restoring or replacing it is part of keeping the elbow stable.

Symptoms

Common findings after a fall include:

Pain and swelling on the outer side of the elbow
Pain and limitation turning the palm up and down
Tenderness directly over the radial head
A sense of blocking or catching with forearm rotation in displaced fractures

Dr. Lee's approach

Dr. Lee's first priority is to see the whole injury, not just the fracture, by checking the elbow for stability and looking for ligament injuries and forearm involvement. Many radial head fractures are stable and do well with early motion rather than prolonged immobilization.

When a fracture is displaced and blocks motion, it is fixed with small screws and plates, or, when it is too fragmented to repair, it is replaced. Dr. Lee uses fixation hardware, including elbow plating systems he helped design, and emphasizes starting motion early to protect against the stiffness the elbow is prone to.

Non-surgical treatment

Stable, minimally displaced fractures are treated with a brief period of support followed by early motion. Starting to move the elbow within the first 4 weeks, once it is safe, is the best protection against stiffness.

Surgical treatment

Displaced fractures that block rotation are fixed with small screws or plates. When the radial head is too fragmented to reconstruct, or instability requires it, it is replaced with an implant. Dr. Lee uses elbow fixation hardware he helped design and prioritizes early, protected motion afterward.

Not uncommonly, radial head fractures are part of a much larger problem including ligament ruptures. Dr. Lee has helped to design anchors used for ligament fixation around the elbow in addition to the plates and screws for the radial head.

Recovery timeline

Recovery centers on early, protected motion:

Weeks 0 to 2
Brief support, then begin gentle motion early once it is safe. Hand, wrist, and shoulder motion encouraged.
Weeks 2 to 6
Progressive range of motion, including forearm rotation, in therapy.
Weeks 6 to 12
Strengthening and a graded return to activity. Some loss of the last few degrees of motion is common.

What patients commonly misunderstand

Two instincts worth resisting:

Long immobilization causes stiffness. The old instinct to keep a fractured elbow still for weeks tends to backfire. For stable radial head fractures, early motion is what protects function.
Look beyond the fracture. A radial head fracture can be the visible part of a larger injury that includes a dislocation or ligament tear. Checking elbow stability and the forearm changes the plan.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

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Hurt your elbow in a fall? Most radial head fractures do well with early motion.

The radial head is the most commonly fractured bone in the adult elbow. Many are stable and recover well with early motion, while displaced fractures are fixed or replaced. The key is to evaluate the whole injury and to avoid the stiffness that comes from immobilizing the elbow too long.

Radial Head Fracture: the common elbow fracture, and early motion.