The ability to move our elbows is required for using our arms during daily activities. We would not be able to reach our face to eat or our feet to put on shoes without our elbows.
Three bones make up the elbow: the long bone closer to your shoulder is the humerus, and the two forearm bones are the radius and ulna. See the image above to get an idea of the location of these bones.
The radius and ulna are involved in bending and straightening the elbow as well as turning the palm up and down. Radial head fractures affect all of these motions, especially the ability to rotate the forearm and hand.
A radial head fracture can result from a fall onto an outstretched hand (FOOSH). Fortunately, most radial head fractures can be treated simply with movement guided by a hand therapist, or, occasionally, with a brace or splint, depending on the severity of the injury. On rare occasions, surgical repair of the fracture is required. Healing time for a radial head fracture takes about 6 weeks on average.
How can a hand therapist help?
Often, there is discomfort and swelling after the injury or surgery. A hand therapist can assist in regaining the movement of the elbow and arm as well as controlling any pain and swelling using different modalities such as ice or heat, or electrical stimulation. They can recommend safe activities to help regain strength and use during day-to-day activities and help adapt current daily activities to improve functional independence. They also help maintain the motion of uninvolved joints like the shoulder, wrist and fingers to prevent secondary stiffness due to a lack of use.
Treatment after a radial head fracture includes motion exercises. A hand therapist decides when active range of motion (exercises using muscles to move the joint) or passive (movement assisted by the uninjured hand or the therapist) is appropriate. Safe motion decreases stiffness and swelling, which improves pain levels. Range of motion exercises include bending and straightening the elbow as well as rotating your forearm with the hand palm up and palm down.
If a radial head fracture requires surgery, the bone is stabilized with a metal plate or screws. Surgery always carries a risk, but the benefit is a stable bone that can be moved safely and more quickly during recovery. Post-surgical radial head fractures may be placed in a cast or splint for a short amount of time and then into a removable splint or brace to allow movement.
If surgery is required after a radial head fracture, an important piece of the rehabilitation plan is the movement of the scar. Scars can limit motion, cause pain, and can be more sensitive than surrounding tissue. Gently massaging the scar in different directions can help decrease sensitivity and improve the scars condition.
Your therapist helps encourage confidence during day-to-day tasks and provides alternative methods for regaining independence more quickly. Be patient! Sometimes heavier tasks such as opening a tight, new jar or lifting a heavy grocery bag can take 2-3 months to perform pain-free after injury and/or surgery. You can find a hand therapist by clicking here.
Gwen Morris, OTD, OTR/L, CHT is a Certified Hand Therapist and a member of the American Society of Hand Therapists.