Overview
A radial head fracture is a break in the radial head, the rounded part of the radius bone that helps form the elbow joint and supports forearm rotation. This injury often occurs after a fall onto an outstretched hand with the elbow slightly bent, which can transmit force into the elbow. Pain is usually worst on the outside (lateral) of the elbow and with rotating the forearm. Even when the fracture does not require surgery, stiffness and weakness are common because the elbow needs protection while it heals.
Symptoms
Patients typically feel pain on the outer side of the elbow that worsens with lifting, pushing off a chair, or turning the palm up or down. Swelling and tenderness are common, and bruising may appear over the next day or two. Many people notice reduced elbow range of motion, especially when trying to straighten the elbow or rotate the forearm. If the injury is more severe or involves joint instability, symptoms may include clicking, a sense of shifting, or a marked inability to use the arm normally.
Causes
Radial head fractures most commonly happen from a fall onto an outstretched hand, driving force up through the forearm into the elbow. Direct impact to the outside of the elbow can also cause this fracture. The fracture pattern varies, but pain and stiffness occur because the joint surface and surrounding soft tissues swell and are irritated during healing.
Risk Factors
Risk is higher in people who fall more often, such as older adults, people with balance problems, or those with vision impairment. Sports or activities with a higher chance of falls-like skiing, cycling, or contact sports-also increase risk. Osteopenia or osteoporosis can make fractures more likely even with lower-energy impacts.
Prevention
You can reduce risk by improving balance and strength through regular exercise, especially ankle and core conditioning, and by using appropriate protective gear for high-risk sports. In daily life, reducing fall hazards such as loose rugs, poor lighting, and clutter lowers the chance of landing on an outstretched hand. After a prior fracture, gradually strengthening the shoulder, elbow, and forearm with guidance from a clinician can help protect the arm during future activities.
How the Diagnosis Is Evaluated
Clinicians start with a history of how the injury happened and how the symptoms started, including whether the pain is lateral and whether forearm rotation is painful. A physical exam checks elbow motion, tenderness over the radial head, swelling or bruising, and forearm rotation compared with the other side. Imaging usually begins with X-rays to confirm the fracture and assess alignment, and additional views or advanced imaging may be considered if X-rays are unclear or if multiple injuries are suspected.
Nonsurgical Treatment Options
Nonsurgical care focuses on pain control, protecting the joint briefly, and then restoring motion safely. Many patients benefit from a short period of immobilization or a sling for comfort, followed by early, guided range-of-motion exercises to prevent long-lasting stiffness. Physical therapy typically helps rebuild forearm rotation strength and elbow mobility while monitoring pain and swelling. Over-the-counter or prescribed anti-inflammatory or pain medicines may be used if appropriate for your health history. A hinged elbow brace may be recommended in some cases to limit painful extremes while allowing safe movement. In selected patients with persistent post-traumatic elbow pain or inflammation after healing, a clinician may discuss image-guided corticosteroid injection, though this is not a routine first-line treatment for the fresh fracture.
When to Seek Medical Attention
Seek prompt medical evaluation if you suspect a fracture after a fall, especially if there is significant swelling, bruising, deformity, or severe pain with forearm rotation. Get urgent care or emergency help if you cannot use the arm, have rapidly worsening swelling, numbness or tingling in the hand, or signs of poor circulation such as pale or cold fingers. You should also seek timely care if fever develops or if pain remains severe despite rest and basic pain control, because complications or associated injuries may need treatment.
Frequently Asked Questions
Many radial head fractures heal well with nonsurgical care, especially when the bone fragments are stable and aligned.
Early, gentle motion is often encouraged after an initial protection period, but the exact timing should follow your clinician's guidance based on your fracture severity.
Yes, physical therapy is usually key to reducing stiffness and rebuilding strength after the initial healing phase.
Next Steps
If you have pain on the outside of your elbow after trauma, arrange an in-person evaluation so X-rays can confirm the fracture and rule out associated injuries. Follow the activity limits and motion plan your clinician recommends, and use prescribed or over-the-counter pain relief safely while beginning guided range-of-motion and physical therapy when appropriate.