Approximately 4.3 percent of all fractures occur at the elbow joint, according to a 2012 survey published in "The Open Orthopaedics Journal." The radial head -- the upper end of one of the forearm bones -- is typically fractured after a fall on an outstretched arm. Because the elbow joint is prone to stiffness, exercises are typically necessary to improve hand and arm function after this injury.
Three bones come together to form the elbow joint -- the humerus, or upper arm bone, and the radius and ulna of the forearm. The radius bone is located on the thumb side of the forearm. The top of the bone, or radial head, has a rounded shape and is surrounded by the annular ligament, which helps keep the bone in place. The elbow joint is a hinge that allows for bending and straightening. The radius and ulna form a joint just below the elbow called the proximal radioulnar joint. The radius crosses over the ulna as the forearm pronates, or rotates into a palm-down position. The radial head rotates inside the annular ligament during this movement.
Range of Motion
Elbow stiffness is common after radial head fracture. Range-of-motion exercises are performed to restore movement and improve function. Although exercise programs vary, 30 repetitions of each exercise performed three times each day is a common recommendation. These exercises are often started early in the healing process, as long as the bone is stable. Finger exercises are performed to maintain flexibility in full-fist and straight-finger positions. Thumb bending and straightening are performed, as well as opposition -- touching the tip of the thumb to each finger. These exercises also promote blood flow, reducing swelling in the hand and forearm. Wrist movement is affected by a radial head fracture. Muscles that bend and straighten the wrist also cross the elbow joint. Forward and backward wrist bending as well as wrist circles help maintain flexibility of the joint. Elbow and forearm range of motion exercises are performed when advised by your doctor. Elbow bending and straightening are performed with the forearm in three positions: palm down, thumb up and palm up.
Strengthening exercises are indicated when advised by your doctor. Elbow, wrist and forearm exercises can be performed using a soup can. A typical exercise program involves holding each movement for three seconds and repeating up to three sets of 10 repetitions each, once or twice daily. Your program may differ depending on your circumstances. Elbow strengthening is performed in the same positions used to improve range of motion. Holding a soup can, the elbow is fully bent then slowly straightened. This exercise is repeated in three positions: palm down, thumbs up and palm up. Wrist exercises are performed with the injured arm resting in a palm-down position on the table, holding the soup can with the hand hanging over the table edge. The wrist is bent upward and then slowly lowered while the forearm remains resting on the table. This exercise is repeated with the pinky side of the forearm resting on the table and again in a palm-up position.
Grip-strengthening exercises improve your ability to use your hand after a radial head fracture. Hand muscles become weak with decreased use of the injured arm. Grip-strengthening exercises can be performed for five minutes, three times each day by squeezing a tennis ball, therapy putty or exercise equipment designed for this purpose.
- The Open Orthopaedics Journal: A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture
- Memorial Sports Medicine Institute: Radial Head Fracture of the Elbow Rehabilitation Exercises
- Kaiser Permanente Physical Therapy Residency & Fellowship Program: Radial Head Fracture Repair and Rehabilitation
- Orthopedics: Current Concepts and Controversies in the Management of Radial Head Fractures
- The American Journal of Orthopedics: Radial Head Fractures and the Role of Head Prosthetic Replacement -- Current Update
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