Radial Fracture Won’t Heal

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Question

Dear TAI Experts:

I fractured my radial head on March 7, 2009. I had 2 weeks in a sling, then began a month of physical therapy. It is July 4 and I still have inflammation, loss of extension, mild pain, and mild loss of use. What can I do? I was released by the dr. after an MRI showed it had healed but I still had inflammation. (That was in May).

Answer

Without doing an examination of your elbow I cannot comment specifically on your condition. In general, loss of range of motion, especially elbow extension, is a major finding following fracture to that region. Although your fracture may be healed, it is not impossible to gain range at this point. Furthermore, although an MRI may have indicated a healed bone, other structures may have also been injured when you had your fracture, including ligaments and cartilage. These may be difficult to image depending on the type of MRI. Swelling can also limit your range and contribute to pain, because fluid takes up space within the joint. A follow-up evaluation with a physical therapist to address your specific impairments is recommended. Generally, following a fracture to the radial head that does not require surgery, therapy will consist of modalities for pain control and reduction of inflammation, mobilization techniques (including manual therapy and soft tissue mobilization to prevent major loss of motion), and strengthening of the region.

Leslie Girard, PT, DPT