Radial head fracture in Vienna
A fall onto the outstretched hand, then pain on the outer side of the elbow and a rotation of the forearm that barely works any more: that is how a radial head fracture begins. I clarify the findings together with any accompanying injuries and accompany you through the aftercare.
In short
A radial head fracture is a break of the upper end of the radius and the most frequent fracture at the elbow. The cause is almost always a fall onto the outstretched hand. Typical are tenderness on the outer side, swelling from the effusion in the joint and a painful rotation of the forearm. If the fracture sits undisplaced, I treat it without an operation: brief immobilisation, then deliberately early movement under X-ray control. If a fragment is displaced or blocks rotation, I stabilise it surgically, usually with countersunk screws.
What is a radial head fracture?
The radial head is the dish-shaped upper end of the radius. It rolls against the humerus and at the same time turns past the ulna — every turn of the palm upwards and downwards runs through this small joint. It also braces the elbow against opening up sideways and takes part of the load that arrives from the wrist.
It is exactly this flow of force that breaks it: if you catch a fall with the arm extended, the humerus presses against the radial head. Fractures are classified by displacement — a crack without offset, a fragment broken off and displaced, a break into several pieces. Fractures with an accompanying injury form a group of their own, for instance together with an elbow dislocation or a torn ligament.
The other two bones at the elbow break as well. The fracture of the bony point at the back, where the triceps tendon inserts, is called an olecranon fracture; here the muscle pulls the fragments apart. A fracture of the humerus close to the joint calls for a careful assessment of the joint surface. What they all share: the elbow tolerates long immobilisation poorly.
Typical symptoms
- Tenderness on the outer side — exactly over the radial head.
- Swelling — the joint fills up, and the arm is held slightly bent.
- Painful rotation — door handles, keys and bottle caps become an obstacle.
- Restricted extension and flexion — the last degrees are missing.
- A blocking sensation — a displaced fragment catches when you turn the forearm.
- Tingling or numbness — a sign of an irritated nerve.
How I make the diagnosis
First I ask how the fall happened, then I examine the arm: I palpate the elbow, check extension, flexion and both directions of rotation, test the collateral ligaments and check sensation and circulation in the hand. The proof comes from X-rays in two planes, which I arrange; with fine cracks the effusion on the image is the only sign. For comminuted fractures I add a computed tomography scan, and where a ligament injury is suspected an MRI. In the practice I use ultrasound to follow the effusion and the soft tissues over time. Unclear complaints are sorted out by the overview of elbow pain.
Treatment: conservative first
The undisplaced fracture is the usual case and needs no operation. I immobilise the arm in a splint for as long as the pain demands it, and then begin with guided movement. That is not a concession to impatience: the elbow scars quickly, and a loss of extension is easier to avoid than to correct later.
X-ray checks show whether the position holds, and in parallel we build the function back up. For that build-up, physiotherapy and exercise therapy are available in the same building at the Orthozentrum Döbling, with magnetic field therapy alongside. Your own part is to keep the shoulder moving, to use the hand and to avoid propping yourself up. When gripping, work and training are possible again depends on the type of fracture and on the follow-up image.
When an operation is necessary
A clearly displaced fragment, a mechanically blocked rotation, a break into several pieces and the combination with a dislocation or a torn ligament all argue for stabilisation. Screws countersunk into the bone restore the joint surface; for larger fragments a slim plate is an option. A collateral ligament torn along with it I repair in the same procedure, so that no elbow instability is left behind.
If a block to movement or a loose body remains later on, elbow arthroscopy helps: through small portals I release scar tissue, remove bony outgrowths and take out loose bodies that get in the way. More on this on the page about the stiff elbow.
I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. How the reimbursement works is explained under private practice and reimbursement.
Whether an operation makes sense depends on the findings. The X-ray, any accompanying injuries and the demands you place on your arm together form the picture — we make the decision together after the examination. The overview is given by the page on elbow surgery in Vienna.
Frequently asked
Common questions about a radial head fracture
Not always. If the head sits undisplaced, I treat the fracture without an operation: brief immobilisation to ease the pain, then guided movement and X-ray checks that show whether the position holds. A displaced fragment, a blocked rotation of the forearm, a comminuted fracture or a torn ligament argue for stabilisation. Which route suits you depends on the findings.
The elbow takes long immobilisation badly: capsule and soft tissues scar, and the fracture turns into a loss of extension. I therefore immobilise only for as long as the pain demands it, and then begin with guided exercises. How much movement is allowed depends on the stability of the fracture and on the X-ray check.
Both affect the elbow, but different bones. The radial head lies on the outer side and carries the rotation of the forearm; it usually breaks in a fall onto the outstretched hand. The olecranon is the bony point at the back, where the triceps tendon pulls. A displaced olecranon fracture is usually stabilised, because the pull of the muscle draws the fragments apart.
A loss of movement is possible, most likely in full extension. Early movement, physiotherapy and a guided build-up work against it. If a troublesome deficit remains, I look for the cause: a scarred capsule, bony outgrowths or a loose body. Whether an arthrolysis makes sense we decide together after examination and imaging.
Not as a matter of principle. Screws countersunk into the bone usually cause no trouble at the radial head and may stay where they are. An implant that blocks rotation or presses on soft tissue argues for removal, as does your own wish. The condition is a fracture that has healed through, which I check on X-ray. As a rule there is no hurry.
Yes, that is a frequent reason for an appointment. I look at the images and the medical letter, measure the range of movement, follow the position over time and match the physiotherapy to it. Please bring everything you have: e-card, X-ray, CT or MRI images and previous reports. You do not need a referral.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.