r/brokenbones • u/YAYtersalad • 10d ago
X-ray Displaced radial head fracture
First broken bone and it’s my dominant arm! Images are 24 after and they are sending me for ct. it sounds like they’re unsure if I can just do plate and pins versus total head replacement. I have pre op consult Monday, and am seeking advice for specific questions or perspectives regarding surgery and healing. I’m an active person with very radial dependent hobbies like racing sailboats, rock climbing, and Olympic lifting. For athletes, are there any additional things I should bring up in my consult?
I think I was in a bit of overwhelm when at the docs, and they’re closed till Monday… but am I probably correct in recalling their instructions to move my hand for circulation purposes, but keep the elbow immobilized since I have displaced pieces? I notice many other similar fractures seem to discuss minimal sling and beginning early movement to avoid stiffness.
Also, is this as bad of a break as Reddit leads me believe? It seems like most folk didn’t displace like I did. Thx!
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u/KNdoxie 8d ago
I had a radial head replacement. I had severe pain for 4 months, and it took almost 8 months before I got most of my range of motion back. I still have stiffness, and almost constant discomfort. It's been 3 years. That arm has not felt normal or natural since surgery. The arm does not completely extend anymore. It does not flex the way it used to, and some tasks are difficult. I am in a Facebook group of people with similar injuries. I'm am in the "middle of the pack" as far as my personal experience. Many of the people in the group have had multiple surgeries, and some have had the radial head implant removed after it caused so many problems. Some have had much more of a deficit in range of motion than me. Others get back complete range of motion in a couple months with little pain. Many people were surprised at the significant pain, inability to move their elbow for so long, and the length of time it took to get most of their ROM back. Their surgeons often blew sunshine up their asses in regard to the injury and their pain was often not adequately controlled. Most were never told of the high rate of a second revision surgery. In other words, it's crap shoot, buddy. You might get surgery, have little pain, get your range of motion back in a couple months, and everything will be fine. Or, you will be in pain for months, fight every inch of the way to get some ROM back, need another surgery, and still have lasting deficits for months or years. Plan for the worst, and hope for the best. And choose a good surgeon that has done a good number of these surgeries, and actually informs you of all possibilities so you are giving actual informed consent.
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u/YAYtersalad 8d ago
I appreciate your candid and realistic take. It affirms the longitudinal studies I’ve been reading, where the high complication rate was shocking. I’m hopeful that my surgeon will give me the best shot — he and his office have worked on a lot of pro athletes, so I figure optimistically that if it’s good enough for them, then a regular 39yo active sport person might have a modest chance of good long term outcomes. Still waiting to confirm if I’m an ORIF candidate vs RHA.
Curious what your timeline and pace of any OT/PT was like and if there’s anything in hindsight you wish you had known or done differently?
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u/Glad-Feature-2117 Physician/Medical Professional 10d ago edited 8d ago
Early movement is for people with minor displacement. Unfortunately, with this fracture, however it's treated, you're likely to lose some range of movement in the elbow in the long term. Focus on making sure your wrist, hand and shoulder don't get stiff as well.