Management of radial head fracture

A fracture involves not only bone, but also surrounding soft tissues. Attention to soft tissue injury may help prevent long-term complications such as contractures, weakness, instability and loss of proprioception. Appropriate treatment is directed at three phases of healing: inflammation, repair and remodeling. The two- to seven-day inflammatory phase is controlled with rest, ice, elevation, immobilization and medications to reduce the pain and swelling. Immobilization during the two- to eight-week repair phase promotes bone healing but may lead to contractures and loss of strength if continued for too long. Physical therapy during the several-month remodeling phase helps restore strength, range of motion and proprioception. Although six to eight weeks is a usual estimate for fracture healing, the actual time can be affected by the type of fracture and the person's age, nutritional and health status, and medication use. This review of the diagnosis and treatment of radial head fractures illustrates the importance of directing the treatment toward the three phases of healing.