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Radial Head Fractures Thoughts?

92K views 132 replies 50 participants last post by  Lisa12 
#1 ·
So I'm riding in an area I was unfamiliar with and going much faster than I should have been for not knowing the terrain. That was, in hindsight, a bad idea... but to make matters worse my gear snaps. Basically I'm pedaling air for about a half second. Never happened before and scared the crap out of me.

I look down for that quick second taking my eyes off where they should have been and blammo! Hit a bump, went airborne, and over the front... smack and both elbows broken.

My right took the majority of the force. The left, unfortunately, was also jacked up. My right was broken in a couple places and looked like like two big pieces of a jigsaw on the xray. The left was broken with a slight step out.

Anyway I'm now almost six months out from my surgery. I can't tell you how nice it is to be able to feed myself, drink, wash, shave, brush teeth... and well... go to the bathroom myself :)

My left arm feels fairly normal. It's not back to where it was but it's darn close. My right though... it's still very stiff. I don't have much in the way of flexion or extension.

I was wondering if anyone had similar experience and if your situation improved.

I've read that six months is about the window for the most amount of improvement... generally speaking. So now I'm obviously concerned that I may never be able to ride again.

I tried a couple times and I can ride, but it's fairly painful when I hit any kind of bump. I still can't do any kind of "pushup" with my right arm either.

Just hoping someone in here will give me some good news... like they had the same situation and it improved hehe.

Anyway thanks for any insight.
 
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#77 ·
here is my story:

riding in soquel demo forest here in the sf bay area on a steep section of trail, went over the bars. landed on my left hand which was outstretched, heard a crunch, and saw my forearm pointing in the wrong direction. not being a doc, i had no idea what was going on, i just assumed that the radius and ulna were broken to permit that kind of direction.

it turned out to be a radial head fracture. luckily, i was able to avoid surgery, and am currently doing physical therapy. this happened on 7 Aug 2010, so its been a few months. i have most of my flexion, pronation movement back. extension is still only abt 80%, plus the tendons and connective tissue that were avulsed are still swollen and tender. my physical therapist says that w/ due care adn diligence, i should get everything back fingers crossed (i'm still not cleared to ride).

key takeaways:

1. get as MANY orthopedic surgeon opinions as you think you need--the first two surgeons i saw wanted to operate right away. the third one was a bit more experienced, and noted that a few weeks in a splint should suffice and then PT should start asap. my buddy who is an orthopedic surgeon also told me that a lot of places are money making operations (so they will push for surgery even if not needed)

2. get a good physical therapist that you are comfortable with, and that actually pays attention to the exercises you are doing to ensure proper movement, and to recommend changes as needed.

3. you should get a set of exercises to do at home as well--you have to be very diligent about doing these---i saw big improvements in my range of motion when i started doing the home exercises 2x a day

hope that helps
 
#78 ·
Thanks for all the replys guys. Definatly helpfull.

I went otb and fractured my right radial head on 10/28/10
One week later I had surgery and one screw installed on 11/4/10
I've been doing stretches on my own for pt but I don't think it's working as i have had no progress in the past few weeks.

Its so aggrivating being able to ride a bike but not being able to RIDE a bike.
 
#80 ·
if its been 4 months, then i would think that any breaks in the bone have already healed. the pieces of my radial head that i broke were displaced by a few mm, but the doc said its fine, the body smooths out the discontinuity so that you end up w/ a smooth surface.
 
#81 ·
dth656 said:
if its been 4 months, then i would think that any breaks in the bone have already healed. the pieces of my radial head that i broke were displaced by a few mm, but the doc said its fine, the body smooths out the discontinuity so that you end up w/ a smooth surface.
My crack was also displaced by a few mm : so its the discontinuity in the break that has to smooth over before you get realignment , or does the entire - bone get wacked out by a few mm & has to realign ?

Or both im bit unsure as im still unable to fully extend the elbow ?
 
#82 ·
Tommy.B said:
My crack was also displaced by a few mm : so its the discontinuity in the break that has to smooth over before you get realignment , or does the entire - bone get wacked out by a few mm & has to realign ?

Or both im bit unsure as im still unable to fully extend the elbow ?
tommy b,

it probably depends on the exact geometry of your fracture. on mine, if you imagine the radial head as a sphere, the pieces that broke were on the periphery of the sphere,a nd they got shifted downwards by a few mm. it was that discontinuity t hat the doc told me would smooth over w/ time, enabling the humerus to move smoothly. also, i'm at month 5, and i'm still not able to fully extend the elbow--i can almost get there, but not quite. the doc told me that it will take several months to get that last range of motion back.

my recommendation would be to avoid being shy about asking the doc question until you understand things to YOUR satisfaction. the first two ortho's i saw were not good about answering questions at all.
 
#83 · (Edited)
dth656 said:
tommy b,

it probably depends on the exact geometry of your fracture. on mine, if you imagine the radial head as a sphere, the pieces that broke were on the periphery of the sphere,a nd they got shifted downwards by a few mm. it was that discontinuity t hat the doc told me would smooth over w/ time, enabling the humerus to move smoothly. also, i'm at month 5, and i'm still not able to fully extend the elbow--i can almost get there, but not quite. the doc told me that it will take several months to get that last range of motion back.

my recommendation would be to avoid being shy about asking the doc question until you understand things to YOUR satisfaction. the first two ortho's i saw were not good about answering questions at all.
Hiya dth & thankyou kindly for youre response :thumbsup:

Sounds like a very similar injury to mine m8) , im also @ month 5 & cant fully-extend almost there but it feels like a "lock-up" on the edge of the elbow thats preventing the full-extension.

Take a look @ the diagram if you can m8) as i have a feeling this illustrates the type of injury youre describing & would be very-similar to mine.

We'll just have to give-it several more months:madman: & wait for that bone to smooth-over to see how much range of motion will return.

Stay tuned there bro , i'ii keep you updated on the recovery & thankyou for youre post :thumbsup:
 

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#108 ·
Look mum - both hands

Take a look @ the diagram if you can m8) as i have a feeling this illustrates the type of injury youre describing & would be very-similar to mine.

We'll just have to give-it several more months:madman: & wait for that bone to smooth-over to see how much range of motion will return.
Me too. This summer I hauled my unfit bones up the Mont Ventoux while on holiday in France. Less than a week later, riding to the office on my first day back at work, I went straight over the bars and landed on my hands. So now I have radial head fractures to BOTH arms.

I went to the hospital today to have my two-week check-up. The doctor is more concerned about the right than the left, because moving it hurts much more. Basically, the x-ray looks just like Tommy B's in his post from January. And the doctor told me the same thing - I have to wait for the bone to smooth out.

Meanwhile, I'm having to learn how to do everything with my left hand /arm - even though that's broken too. I don't normally post to these discussions, but I'm so pissed off that I had to try to get it all off my chest. Good luck to everyone with their recoveries.
 
#84 ·
Well, 10 months in and still cant fully extend my arm, cant turn my wrist up or down all the way and it constantly pops and cracks, and I still am in pain.. Im just getting used to it.. BUT I have all my strength back... I can do push ups and pull ups no problem. my small type 1 fracture has been a complete nightmare...

Did 8 week of PT
3 months of Active Splint to extend the arm

all for nothing.

I havent been to my doc in 4 months so I think Im gonna go back but Im sure surgery is the only option at this point..
 
#85 ·
The 1st big test today for me was back on the job loading / unloading containers , the elbow held-up still didnt put all the force into the right arm but feck im pretty -happy with the result :

still cant -fully extend after 5 months but i guess that will come over time:thumbsup:
 
#86 ·
Tommy.B said:
The 1st big test today for me was back on the job loading / unloading containers , the elbow held-up still didnt put all the force into the right arm but feck im pretty -happy with the result :

still cant -fully extend after 5 months but i guess that will come over time:thumbsup:
tommy b,

good to hear that your elbow is holding up--one thing that for me is limiting full extension is the fact that the 2 weeks in the splint caused my bicep to shrink, and other connective tissue to atrophy as well. basically, the body thinks that the position in the splint is "normal", and adjusts accordingly--this limits the range of motion. so far, physical therapy is helping me w /this, but its slow going at this point.

also, i've started using my arm more, but i tried moving to 5 lb weights from my current 3 lb weights, and that caused a lot of pain and swelling, so i backed off.

it may sound stupid, but i also try and do breathing exercises to relax, and to be able to stretch my arm out more (as part of my physical therapy). it helps me get a little bit more movement, at least during the therapy session
 
#87 ·
dth656 said:
tommy b,

good to hear that your elbow is holding up--one thing that for me is limiting full extension is the fact that the 2 weeks in the splint caused my bicep to shrink,
I was 4 weeks in a sling & when then docs took it of , i literally had no muscle left or very little , i could hardly move -it : it was like a block of ice:rolleyes: :rolleyes:
 
#88 ·
dth656 said:
tommy b,

and other connective tissue to atrophy as well. basically, the body thinks that the position in the splint is "normal", and adjusts accordingly--this limits the range of motion. so far, physical therapy is helping me w /this, but its slow going at this point.
I was initially & still afraid of twisting the elbow into any other position then the :splint" & the weight exercices my physio has my on , especially when i apply "full" force on heavy objects either picking them up or placing them down is still a problem for me.
 
#89 ·
dth656 said:
tommy b,

also, i've started using my arm more, but i tried moving to 5 lb weights from my current 3 lb weights, and that caused a lot of pain and swelling, so i backed off.
Im on 4 k with the bicep-curls & 2 k with the arm - extensions.

The fracture is still evident however i feel that the :"displacement" or "discontinuity" as you said is starting to smooth- out as that 'edge" on the bone is feeling a bit smoother.

We'll give -it another 7 months as you said ,you where was pretty much spot-on :thumbsup:
 
#90 ·
Here i am @ 5 months physio but i was covered by work , so i had the time everyday to work on my arm for 4 hours with the stretching & weight exersices my physio has me on.

I have to continue with the weight to compensate for the weekness on the joint so my physio tells me.

Its nice to talk with someone who has a similar injury that occured around the same time & to compare sum results :thumbsup:

I'ii keep the updates over the next 7 months & hopefully we'll come-up ALRITE :thumbsup:
 

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#92 ·
Damn, I hope all of you heal up quick. I've broken every major joint in my left arm from either biking or snowboarding. The left wrist took over 6 months to make a fist, more than a year to hold it. My elbow still catches occasionally and took about 6 months to get normal (not strong) again. The shoulder was the worst since it broke and I didn't see a doc for over a month. After a surgery to grind down bone spurs and remove part of the bursa sack it's stronger but still not like the right one. Thankfully I can still ride both sports pretty hard with minimal pain. DEFINITELY go to physical therapy, especially at a sports specialty clinic. Do that stuff religiously, even when you're cleared. If you can afford it hire a personal trainer that will help you strengthen all your little stabilizer muscles, otherwise bigger muscles take over and limit your range of motion. Good luck to all of you!
 
#93 ·
I did my left RH in June, 2009 going over the bars. Doc wasn't sure if she was going to operate or not. 50/50. Took me into her office, lied me down, got me talking about how it happened and WHAM. Rotated my wrist around full extension. JESUS. Doc goes, well thats what I needed to see, it will rotate. That sound and pain are not forgotten.

6 months of super fun PT and I was back to 90% extension and rotation. I am now back at full extension and rotation. Still, at times, creaks and cracks like a 90 year old arthritic , gets stiff at times and sore in damp weather. Hopefully though, continues to get better over time.

PT PT PT PT PT PT. Do it. It sucks but it works. My PT said it would take years to get it back to where it was pre-break. Turns out she was right.
 
#95 ·
TeCeBe said:
I did my left RH in June, 2009 going over the bars. Doc wasn't sure if she was going to operate or not. 50/50. Took me into her office, lied me down, got me talking about how it happened and WHAM. Rotated my wrist around full extension. JESUS. Doc goes, well thats what I needed to see, it will rotate. That sound and pain are not forgotten.

6 months of super fun PT and I was back to 90% extension and rotation. I am now back at full extension and rotation. Still, at times, creaks and cracks like a 90 year old arthritic , gets stiff at times and sore in damp weather. Hopefully though, continues to get better over time.

PT PT PT PT PT PT. Do it. It sucks but it works. My PT said it would take years to get it back to where it was pre-break. Turns out she was right.
There bugger's these type of fractures , i spent 6 months of heavy - physio on mine with a 2mm gap on the radial - surface , about 10 months in for me now & very pleased with the results so far : Its my crowning achiement:thumbsup: :thumbsup:

Got looked after by the best pysio's & doctors : i can still feel it lifting or pulling very - heavy items but i guess thats just strenght of the mind from here guys:thumbsup::thumbsup:
 
#96 ·
Tommy.B said:
There bugger's these type of fractures , i spent 6 months of heavy - physio on mine with a 2mm gap on the radial - surface , about 10 months in for me now & very pleased with the results so far : Its my crowning achiement:thumbsup: :thumbsup:

Got looked after by the best pysio's & doctors : i can still feel it lifting or pulling very - heavy items but i guess thats just strenght of the mind from here guys:thumbsup::thumbsup:
hey tommy b, good to hear that you are recovering well. i'm still doing physio (i go bi weekly now, and do the exercises at home 2-3x a week), but its still swollen and painful after almost 9 months. this is due to the dislocation and damage to soft tissue, but its slowly getting better. i'm cleared to mtb once a week, so i do that, and otherwise, i try to walk/run to get outside and stay fit.

when i combine motions (pronation with the elbow bent, like when you floss your teeth), i hear a crunching noise from the joint--the phsyio folks say thats normal, and will take more time to heal.
 
#97 ·
dth656 said:
hey tommy b, good to hear that you are recovering well. i'm still doing physio (i go bi weekly now, and do the exercises at home 2-3x a week), but its still swollen and painful after almost 9 months. this is due to the dislocation and damage to soft tissue, but its slowly getting better. i'm cleared to mtb once a week, so i do that, and otherwise, i try to walk/run to get outside and stay fit.

when i combine motions (pronation with the elbow bent, like when you floss your teeth), i hear a crunching noise from the joint--the phsyio folks say thats normal, and will take more time to heal.
This is pretty-much the end result of physio & back on the job heading towards 12 months still not quite the full-extention but the strength & elasticity is pretty much there still feel a bit on the outer-edge of the radial : doc reckons that discontinuity in the bone will still continue to heal over time & allowing better extention in the future :thumbsup: :thumbsup:
 
#99 ·
Hey guys I am exactly 1 year and 3 months post accident. I was fine for many months with no pain and 85% full extension.. Well started at the gym last week and now I am in a ton of pain.. I mean I can do a ton of pull ups and push ups, do weight, but then the next day my elbow is very sore and pops and cracks alot and feels like Im losing extension I had.. really sucks! If I stretch my arm out fully it hurts!
 
#100 ·
Interesting thread. Both worrying and encouraging. I am now a whole twenty-two hours in from my crash (so i have a bit of time to surf the net). MTB on road, had just fitted some skinny slick tyres, pushing the speed...went to signal a turn (for my house, so close...) and bam! I'm viewing the sky though my bike frame, which my legs are holding aloft.

I realise that the left wing is busted in some way, so I get a lift to A&E (where it is very quick service all round), have the scrapes cleaned up, and a couple of x-rays. A pretty clean snap of the radial head. The ortho junior is called over, says it is the worst break of that sort he has seen, tests my range of movement and rotation, (limited, decreasing and painful) orders me plastered shoulder to wrist and says to come back to see the consultant the next morning. Says ( I thought) that I will be in plaster for eight weeks and may need surgery (wiring the head up). Sent off with some 30/500 co-codamol.

Next morning I am surprised when the consultant's opening gambit is "we'll just take that plaster off" and there is a nurse standing by with a cutter. Whoa! After a chat she says I could keep the cast on for a week, no longer, as the elbow would start to seize. She also says it is a really bad break, but not one requiring surgery. I do have the cast cut off and now have a simple wrist sling, which has left the arm feeling a bit vulnerable. I am also advised that the next week will be quite painful and I must take painkillers on a schedule, even if not in pain at that point (not those co-codamal though, apparently I should be on the floor after them). And, after about three days, I should start trying some movement, and return in three weeks. Hopefully mostly fixed in around eight weeks, but likely to have residual issues for some time, or permanently.

At the moment, the arm is a bit uncomfortable, rather than in pain. The massively swollen thigh, now that's painful.

Anyway, that's an epic first post, medals if you have made it this far and I'll try and update after my next appoinment.
 
#101 ·
Feel better

Yeah, I just replied on another post about it. I hope you get better. Mine was clean but bad. The sad thing was, I climbed for years, played hockey, skateboarding, and biking and I busted it walking to get the mail. I ate concrete. Bashed up the bursa on my left knee pretty good, minor injury to the rotator cuff, nasty radial head fracture, and a lot of lost skin. That was 3/2010. I did PT right after and got good range of motion back quickly, but was later told I should've been pinned. A year later, I have pain most days and it gets tired and gives out depending on the activity. I can't climb or do push ups too well. I started road biking again last fall, but still haven't gotten back to mountain bike. Anybody this far out still having pain? The obvious answer is go back to the ortho, but I guess I'm afraid they'd want to do something else to it. I have enough surgery on my plate with the knees.:skep:
 
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