Radial Head and Neck Fractures

  Initial Treatment
Splint type & position Long-arm posterior splint
Elbow in 90 degrees of flexion
Consider aspiration of hemarthrosis
Initial follow-up visit Within 1 week
Pt instructions Icing and elevation in first 48 hours
Forearm rotation as soon as pain permits
  Follow-up Care
Cast or Splint type & position Sling for comfort only
Length of immobilization 1 week
Healing time 8 to 10 weeks to restore motion
Follow-up visit interval Every 2 weeks to assess return of normal elbow motion
Repeat radiography interval At first visit to check position or look for signs of initially occult fracture
Pt instruction Active ROM exercises (forearm rotation, flexion, and extension) at least
three to four times each day
Physical therapy referral if no or little progress
Some loss of extension expected
Indications for Ortho consult Fracture dislocation
Mechanical block to motion
>2 mm displacement
>One third of the articular surface involved
>3 mm depression
>30 degrees of angulation
Severe comminution