Video transcript
Let’s go through your injury and what to expect as you recover.
The elbow is a hinge joint, made up of the upper arm bone – the humerus – and the two bones of the forearm – the radius and the ulna. The radial head and neck form the top end of the radius. This part of the bone is important not just for bending the elbow, but also for rotating the forearm – turning your palm up and down.
If the fracture is only minor or not badly out of place, it can often be treated without surgery. The key is making sure the broken pieces stay well aligned and that the elbow remains stable as it heals.
These types of fractures are usually managed with early movement, not strict rest. That’s because keeping the elbow still for too long can lead to significant stiffness, which can take months to fully recover from. The risk of stiffness is often greater than the risk of the bone not healing, so movement is encouraged even while the bone is still healing.
If your fracture doesn’t need surgery, you won’t usually be put in a cast. Instead, you’ll be given a sling to wear for comfort – mainly during the first one to two weeks. After that, you’ll start physiotherapy. This will focus on gently moving the elbow through its full range – both bending and straightening the arm, as well as rotating the forearm. These exercises may feel uncomfortable at first, but they’re safe and important to prevent long-term stiffness.
If your injury is straightforward, you won’t need regular follow-up appointments or repeated X-rays. Many patients recover well without needing to come back to clinic. You’ll usually be discharged with written advice and referred directly to physiotherapy.
Some people, however, have more severe injuries – where the fracture is in multiple pieces, is badly displaced, or is linked to other damage in the elbow. In these situations, we might arrange a CT scan to get a clearer picture and decide whether surgery would help. We also assess for signs of elbow instability, which might not show up on plain X-rays alone.
If surgery is needed, it’s usually done within the first few weeks. When possible, the aim is to fix the bone using small screws. But if the fracture can’t be fixed reliably, the alternative is to replace the radial head with an artificial one. This allows the joint to keep moving and helps protect the surrounding ligaments from long-term damage.
The most common problem after this injury is stiffness – especially when it comes to rotating the forearm or fully straightening the elbow. That’s why we focus on early movement as a key part of treatment.
Swelling and mild bruising around the elbow are common and expected. Using ice, keeping the arm elevated, and starting gentle movements all help reduce swelling and improve comfort. It’s normal for your elbow to look a bit puffy and for the forearm to bruise downwards with gravity in the first few days.
Most patients with a simple radial head fracture make a full recovery within six to eight weeks. The sling is usually just for comfort in the first week. As soon as pain allows, you should start gently moving the elbow.
Some stiffness often lingers, but with regular movement and support from physio, it usually improves steadily over time. By around eight to twelve weeks, most patients are back to normal daily activities, though full strength and flexibility can take longer depending on the severity of the injury.