Understanding Radial Head Fractures and how Physiotherapy can help
A radial head fracture refers to a break in the radial head, which is the top portion of the radius bone in the forearm that helps form the elbow joint. This type of fracture is commonly seen after a fall onto an outstretched hand or in accidents involving the elbow.
Causes:
Falls: The most common cause is falling onto an outstretched hand (FOOSH), where the impact forces travel up the arm to the elbow.
Direct trauma: A blow to the elbow or forearm can cause a fracture to the radial head.
Twisting injuries: Sudden rotation or torque applied to the elbow, such as during sports activities, can also lead to a radial head fracture.
Symptoms:
Pain and swelling around the elbow joint.
Difficulty moving the elbow or forearm.
Tenderness when pressing on the radial head or the outer elbow.
Decreased range of motion in the elbow.
Treatment:
Treatment of a radial head fracture depends on the severity of the break.
Conservative Treatment (Non-surgical):
If the fracture is non-displaced or minimally displaced, treatment typically involves rest, ice, elevation, and anti-inflammatory medications for pain management.
A sling or elbow brace may be used to immobilise the arm for a short period to allow healing.
Gentle mobilisation exercises are introduced once pain subsides to prevent stiffness.
Surgical Treatment:
In cases where the fracture is displaced, comminuted (multiple fragments), or if the radial head is severely damaged, surgery may be required.
Radial head replacement: If the radial head is shattered or severely fragmented, it may need to be replaced with a prosthetic implant.
Radial head excision: In some cases, a part of the radial head may be removed if it cannot be repaired.
Physiotherapy Role:
Physiotherapy plays a critical role in rehabilitation after a radial head fracture, whether the treatment is conservative or surgical.
Early Stages (After the acute phase of healing):
The physiotherapist will guide gentle range-of-motion exercises to reduce stiffness and maintain flexibility in the elbow and forearm.
Ice and modalities like TENS (Transcutaneous Electrical Nerve Stimulation) may be used to manage pain and swelling.
Intermediate to Later Stages:
Strengthening exercises are gradually introduced to rebuild muscle strength around the elbow joint.
Functional exercises will be prescribed to improve coordination and return the patient to daily activities.
The physiotherapist will also assess for any compensatory movement patterns that may develop during the healing process and address them accordingly.
Post-Surgical Rehabilitation:
Following surgery, physiotherapy focuses on restoring normal range of motion, strength, and function.
The rehabilitation process may take several months, and the physiotherapist will monitor the recovery closely to avoid complications like stiffness or weakness.
Outcomes:
The prognosis for a radial head fracture largely depends on the severity of the injury and the treatment approach.
Mild fractures: With proper rehabilitation, individuals can expect a full recovery, regaining normal function and strength in the elbow.
Severe fractures: In cases requiring surgery or with more complex fractures, recovery may take longer, and there could be lasting limitations in range of motion or strength.
Post-Surgery: After a radial head replacement, most patients can return to functional activities, but some may experience persistent discomfort or reduced strength, particularly with high-demand activities like heavy lifting or sports.
In general, the majority of patients who receive appropriate treatment and rehabilitation will see good outcomes, with the ability to return to normal activities, though the recovery timeline may vary.
