What is a radial head or neck fracture? How long does it take to recover? What factors can affect your recovery? Get answers to these questions and more in this detailed guide.

Understanding Radial Head or Neck Fractures

An elbow fracture, also known as a radial head or neck fracture, is a common injury that occurs when the bone at the top of the forearm (the radial head or neck) breaks. This type of fracture can happen due to a fall or impact on the elbow.

When you have a fracture, it’s not just the bone that’s affected – the surrounding soft tissues, including muscles, ligaments, tendons, and nerves, are also injured. This can lead to a range of symptoms and complications that need to be addressed during the recovery process.

Recovery Times for Elbow Fractures

Typically, a radial head or neck fracture takes between 3 to 6 weeks to heal. However, it’s normal to experience aches and discomfort beyond this initial healing period, especially when you try to resume activities you haven’t done in a while. The area may also remain more sensitive for some time after the injury.

Factors That Can Affect Recovery

Several factors can influence the healing and recovery process for an elbow fracture. These include:

• Smoking: Smoking can negatively impact tissue healing and slow down the fracture recovery process. Quitting smoking during the healing phase can help ensure the best possible outcome.
• General Health: Certain medical conditions, such as diabetes, may slow down the healing process. Maintaining a healthy diet and staying active can support recovery.
• Medications: Some medications, including anti-inflammatory drugs like ibuprofen or naproxen, have been shown to delay fracture healing. Speak with a healthcare professional if you have concerns about your medication.

What to Expect After an Elbow Fracture

After an elbow fracture, you can expect the following:

• Stiffness and Pain: Initially, your elbow will feel stiff and painful. However, it’s important to continue moving the joint, even if it hurts, to prevent it from becoming too stiff.
• Sling or Collar and Cuff: You may be given a sling or collar and cuff for pain relief, but it’s important to reduce the use of these as your pain improves to prevent the elbow from becoming too stiff.
• Pain Management: It’s normal to experience discomfort in the areas around the fracture, including other soft tissues and nearby joints. Pain can fluctuate and may persist even after the fracture has healed. Your local pharmacy can provide advice on managing pain.

Reducing Swelling and Bruising

Swelling is a natural part of the healing process, but excessive swelling can become uncomfortable and limit your movement. To help reduce swelling, you can try the following:

• Raise your arm above your heart when resting, using pillows for support.
• Keep the other joints in your hand or arm moving normally.
• Avoid too much rest or too much activity.
• Gently massage the swollen area.

Bruising is also common after a fracture and can be widespread, changing color as you recover.

Getting Back to Normal Activities

Returning to your normal activities, such as driving, work, and daily tasks, will depend on the type of work you do and your employer’s policies. Here are some general guidelines:

• Driving: Before driving, contact your insurance provider to ensure your injury does not affect your coverage. You must be able to perform an emergency stop or maneuver safely.
• Work: Your return to work may involve a phased approach or changed duties. You do not need to see a healthcare professional to return to work.
• Daily Activities: Avoid heavy lifting or weight-bearing activities for at least 6 weeks, until the fracture has fully healed. Gradually increase your activities as your pain allows.
• Sports and Contact Activities: Do not return to contact sports until at least 6 weeks after the injury and when you are pain-free during movement.

Reduced flexibility and strength may make some activities more challenging initially, but this will improve as you slowly build up to your usual routines.

Emotional and Fall-Prevention Considerations

It’s normal to experience frustration or low mood after an elbow fracture. As you gradually get back to your regular activities, your emotional well-being should improve.

Additionally, loss of confidence is common after a fracture. Seek advice about preventing falls to help regain your confidence and reduce the risk of future injuries.

Remember, the recovery process can vary from person to person, and it’s important to follow the guidance of your healthcare professionals to ensure the best possible outcome. If you have any concerns or questions, don’t hesitate to speak with your doctor or local pharmacy.

Elbow (radial head or neck) fracture

Your injury may be referred to as a fracture, break or crack. These terms all mean the same thing.

When you have a fracture, it’s not just the bone that’s affected. You’ll also have injured some of the soft tissues around it. Soft tissues include the:

• muscles
• ligaments
• tendons
• nerves

Elbow (radial head) or neck fracture.

Recovery times

A fracture heals between 3 to 6 weeks after the injury.

It’s normal to have aches and discomfort beyond 3 to 6 weeks. This often happens when you try activities you haven’t done for a while.

It’s also normal for the area to be more sensitive for a while after the injury.

What can affect your recovery?

There are some things that might affect your recovery.

Smoking

Smoking affects all your tissues and slows facture healing times. In some people, it can stop healing altogether.

Stopping smoking as your fracture heals will help to ensure the best recovery.

Get help to stop smoking.

General health

Some medical conditions, like diabetes, may slow down the healing.

Eating a healthy diet and keeping yourself active will help your recovery.

Medication

Some medications can slow down fracture healing. If you have concerns about your medication, talk to a healthcare professional.

Anti-inflammatory medication, like Ibuprofen or Naproxen, has been shown to delay healing.

What to expect after an elbow fracture

This type of elbow fracture is stable and you can move your joint without causing damage.

At first, your elbow will feel stiff and painful. However, it’s important to continue to move it, even if it hurts.

You may be given a collar and cuff or sling for pain relief only. It’s important that you reduce the use of this as your pain improves to prevent your elbow from becoming stiff. The aim is to stop wearing this support as soon as possible, ideally within a week.

Pain after a fracture

It’s normal to have some discomfort in the areas around your fracture, including:

• other soft tissues
• nearby joints
• areas that have been immobilised

Pain can change from day to day and it doesn’t always depend on what you’re doing. It’s common to have pain at rest.

It’s normal to have some pain even when your fracture has healed. Some people also experience discomfort in the fracture site during colder weather.

Your local pharmacy can give you advice on managing pain after a fracture.

Find your local pharmacy

Use Scotland’s Service Directory to find your local pharmacy.

Pharmacies

Swelling

Swelling is the start of healing. It’s normal to have swelling near the fracture. It can then spread down your arm.

The swelling changes with:

• your position
• activity
• the time of day

Even when your fracture has healed it’s normal to have some swelling. This can last for several months.

How to reduce swelling

Having a lot of swelling can become uncomfortable or limit your movement. However, there are some things you can do to reduce the swelling. You can try to:

• raise your arm above your heart when resting – you can do this by supporting your elbow with pillows
• keep the other joints in your hand or arm moving normally
• avoid too much rest or too much activity
• massage the swelling

Bruising

It’s normal to have bruising after a fracture.

Bruising can be widespread and may appear a long way from your fracture. It can be very purple to start with and may change colour as you recover.

Getting back to normal activities

There are some things you should consider when trying to get back to your normal activities.

Driving

You should contact your insurance provider before driving. Your injury may affect your insurance.

Once you’re out of your sling, the general advice is that you must be able to perform an emergency stop or manoeuvre safely.

You should always be in full control of your vehicle.

Work

Your return to work will depend on the type of work you do and your employer. It may be possible to discuss a phased return to work or changed duties.

You don’t need to see a healthcare professional to return to work.

Daily Activities

It can take 6 weeks for a radial head or neck fracture to heal completely. During this time, don’t stress the joint with heavy lifting or weight-bearing.

Don’t return to contact sports until:

• at least 6 weeks after your injury
• you’re pain-free when moving

However, keep doing any activities you’re able to and where your pain allows. Over time, gradually increase what you do.

Reduced flexibility and strength may make things more difficult to start with. This will get better as you slowly build up to all your usual activities.

Mood

Frustration or low mood after an injury is normal. As you get back to normal life this should get better.

Falls

Loss of confidence is common after a fracture.

Get advice about preventing falls.

Bone scanning

You may be sent a letter inviting you for a scan of your bone density after a fracture.

It’s routine to be assessed for any further risk of fracture, especially if you:

• are over the age of 50
• have increased risk factors for fracture

Rehabilitation plan

There are movements you can do to help each stage of your recovery

0 to 3 weeks after your injury

Just after your injury, you should:

• maintain your shoulder wrist and hand movements
• increase movement in your elbow with gentle exercises
• manage your pain and swelling

2 to 6 weeks after your injury

Between 3 to 6 weeks after your injury, you should:

• continue your elbow exercises, making sure you’re aiming for full movement
• pay particular attention to straightening your elbow and turning your palm upwards – you can add gentle pressure from your other hand to stretch out these movements

6 to 12 weeks after your injury

The injury should be healed between 6 to 12 weeks but heavy tasks may cause discomfort.

You should aim to:

• return to full function
• resume normal day to day activity
• return to higher impact activity
• try exercises to regain elbow movement

How to increase movement after injury

It’s important to start exercises as soon as possible after an injury. This will help your recovery and help you to regain normal function.

Consider other parts of your arm when moving, like your fingers, wrist and shoulder. There is nothing wrong with them so don’t let them stiffen as well. Keep all parts moving.

Exercises should be practiced for 3 to 5 minutes every hour. It’s better to do movements little and often, than to do them once a day for a longer period.

Help and support

If your elbow function hasn’t improved within 6 weeks of following this advice, it’s a good idea to talk to a healthcare professional about your symptoms.

Exercises for your elbow

The elbow does 4 movements. It turns your hand palm up and palm down. It can also straighten and bend so that your hand touches your shoulder.

You should try exercises that practise these movements.

Stop these exercises if they make your symptoms worse, or cause new pain.

Source:
MSK Expert Panel – Opens in new browser window

Last updated:


16 December 2022

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Radial head / neck fractures of the elbow

Patient information A-Z

Who is this leaflet for? What is its aim?

This leaflet gives advice on managing a radial head or neck fracture of the elbow, together with suggested exercises.

What is a radial head / neck fracture?

A radial head / neck fracture is a break in one of the bones in your elbow.

This fracture is in a part of the bone that usually heals well with time and movement. It doesn’t need surgical treatment, plaster cast or bandaging and routine follow up is not required.

You can use a sling to hold your arm in a comfortable position for the first few days.

Swelling and bruising at the fracture site is normal. Simple, over the counter pain killers and icing the area will help to reduce swelling and pain. Apply the ice to the area indirectly (for example, by wrapping a bag of frozen peas in a towel) for 10 minutes 3–4 times a day.

You should:

• Reduce the wearing of your sling as your pain settles, and aim to completely remove the sling as soon as you feel able. Try to use it for less time each day.
• Gently stretch your elbow to regain full movement.
• Take simple, over the counter pain relief as needed to keep your elbow moving.

You should not:

• Drive whilst wearing the sling.
• Forcibly stretch your elbow as this is unnecessary and may cause pain, delaying your recovery.

How long will it take to get better?

The pain may take 3–6 weeks to settle down. It could be several months before the elbow feels normal again.

There may be slightly reduced movement at the elbow, especially when you straighten it, but this is unlikely to affect its function.

Should I do any exercises?

Yes! It is important to get your arm moving as soon as possible in order to regain normal movement.

You can do the following exercises immediately after your injury.

Try to do the exercises every 2–3 hours.

Exercise 1

• Sit with your elbow tucked in your side.
• Slowly turn your palm to the floor as far as you can.
• Then turn your palm to the ceiling as far as you can.
• Repeat 10 times or as many as you can comfortably tolerate.

Exercise 2

• Lie on your back.
• Bend your arm and point your elbow to the ceiling.
• Slowly straighten your elbow as if you are pointing to the ceiling, then lower back down trying to get your thumb down to the pillow.
• Repeat 10 times or as many as you can comfortably tolerate.

After an elbow injury your wrist and shoulder can become stiff. These daily exercises will help.

Exercise 3

• Keep your wrist mobile by moving it forwards and back and side to side.

Exercise 4

• Raise your arm overhead as far as you can comfortably. You can do this in any position, for example, lying / sitting / standing.
• You can have your elbow bent and / or in a sling for this exercise if it makes it more comfortable.

Is it normal to get pain when I exercise?

Yes, this is normal and may take several months to settle completely.

However, it should not be severe pain and any pain after exercising should be bearable.

Your elbow should not feel hot, inflamed or develop lots of swelling after exercising.

If your pain following exercising does not settle down within 30 minutes of exercising you should consider:

• Doing shorter bursts of exercises
• Not pushing into your pain too much
• Discussing your pain relief with your GP

If you still find your pain to be severe or unmanageable or are concerned about lack of improvement please contact the fracture clinic on 01223 348299 or your treating consultant.

How often should I exercise?

It is more effective to do small amounts of exercise regularly through the day.

This should mean your exercises are bearable and your arm does not stiffen up between sets.

Please contact your GP if your condition is not improving, or if your pain relief is not adequate.