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Type I Fractures

Type I fractures are generally small cracks, and the bone pieces remain fitted together.

• The fracture may not be visible on initial X-rays, but can usually be seen if the X-ray is taken 3 weeks after the injury.
• Nonsurgical treatment involves using a splint or sling for a few days, followed by an early and gradual increase in elbow and wrist movement (depending on the level of pain).
• If you attempt too much motion too quickly, the bones may shift and become displaced.

Type II Fractures

Type II fractures are slightly displaced and involve a larger piece of bone.

• If displacement is minimal, treatment may involve wearing a sling or splint for 1 to 2 weeks, followed by range-of-motion exercises.
• Small fragments of broken bone may be surgically removed if they prevent normal elbow movement or have the potential to cause long-term problems with the elbow.
• If a fragment is large and out of place enough, the orthopaedic surgeon will first attempt to hold the bones together with screws, or a plate and screws. If this is not possible, the surgeon will remove the broken pieces of the radial head.
• The surgeon will also correct any other soft-tissue injury, such as a torn ligament.

Type III Fractures

Type III fractures have multiple broken pieces of bone which cannot be put back together for healing.

• In most Type III radial head fractures, there is also significant damage to the elbow joint and the ligaments that surround the elbow.
• Surgery is always required to either fix or remove the broken pieces of bone and repair the soft-tissue damage. If the damage is severe, the entire radial head may need to be removed. In these cases, an artificial radial head may be placed to improve long-term function.
• Early movement to stretch and bend the elbow is necessary to avoid stiffness.

After surgery to repair a radial head fracture, the surgeon will recommend no weight-bearing through the arm and no lifting objects heavier than a few pounds for 6 to 12 weeks. Depending on the fracture pattern and other associated elbow injuries, you may be placed in a splint or cast for a period of time.

Even the simplest of fractures may result in some loss of movement in the elbow. Regardless of the type of fracture or the treatment used, you will be prescribed exercises to restore movement and strength before resuming full activities. In some cases, your elbow stiffness may be limiting enough that you require a second surgery to remove scar tissue.