Coping with a Radial Head Fracture

So for folks who might find this via search engine:  Three weeks ago I tripped over my dog, and did a job on my right arm.  The diagnosis is radial head fracture.  I assume you’ve either had someone explain that to you, or you took the time to look it up and now are trying to figure out how to cope with a broken bone when the doctor told you that they weren’t going to put you in a cast.

I know that was the big question for me.  What do you mean you aren’t going to immobilize a broken bone!  But apparently the this sort of fracture tends to be very stable (ie: not likely to move around), so as long as you don’t do stupid things it’ll heal just fine on its own.  And apparently immobilizing the elbow joint is considered a very bad thing.  Which makes sense when I thought about it.  The elbow has a very wide range of motion under normal circumstances, and if you take that away for any extended period you risk locking up the elbow, and getting that motion back would be literally painful.

So they probably gave you a sling, and told you not to lift anything more than a few pounds in weight.  They likely also told you to NOT use the sling as much as possible in order to keep the elbow mobile.

You also probably quickly discovered that wearing the sling is very uncomfortable.  I have no idea how humanity hasn’t come up with a sling that doesn’t hang off your neck, but apparently they haven’t.  Not cool.  I did end up ordering THIS (Amazon affiliate link) sling for myself, and it is indeed more comfortable than the one the doctor’s office gave me, but it still hangs off your neck.  Word of warning, wearing your arm in a sling will screw with your balance and make your back hurt.  Yay.  In my case though the injured arm is my right and dominant hand.  Which means that any time I’m actively doing anything I need to wear the sling or I try to use my injured arm without thinking about it, with painful results.

Which leads to my next topic.  Pain.  As long as I wear the sling it doesn’t hurt.  Within minutes of taking off the sling my whole arm aches from just below the shoulder down through the wrist.  Attempting to straighten my arm fully, or bend it more than 90 degrees, or attempting to lift something more than a couple pounds, results in significant stabbing pains in the elbow (like, 5 or 6 out of ten, or even higher depending on what I was trying to do).  In addition, attempting to open certain hard to open jars and other containers has been painful, while technically within the weight limits I was given, apparently the torque on the arm is too much.  I contacted my doctor at the 3 week mark to find out if it was normal that I was still experiencing this much pain that far in.  They responded that not only is it normal, I can expect pain through at LEAST week 4 and possibly even week 6!  Also most likely they didn’t give you anything for the pain, apparently over the counter anti-inflammatories are the way to go.  Good luck.  I take prescription anti-inflammatories daily for other issues and they didn’t cut it either.

Sleeping…..I sleep on my sides, this meant that my injured arm was forced to either bend further than 90 degrees or straighten fully depending on which side I was on.  Needless to say the first week+ I didn’t get much sleep.  I was also unable to find a comfortable position for my arm lying on my back, and while sleeping in a recliner wearing the sling would have likely been perfect I just can’t sleep that way (I’ve tried, repeatedly).  I finally discovered that wedging an extra pillow at an angle under my arm worked to keep my arm at angle that was comfortable.  I recommend a firm pillow, steal one off the couch if you need to.  Also, if you have hair long enough to get caught under your neck or shoulder when sleeping, and you normally wear it down while sleeping, I highly recommend putting it up into a bun for sleeping for the duration.  When you half wake up in the middle of the night cause your hair is caught under your neck, you’re going to reach up with which ever arm is available to move it.  And if the injured arm happens to be that arm….well, it’s a good way to wake up suddenly anyway!  Note, the same thing counts for stretching when you first wake up…..

Speaking of hair, two tricks to dealing with hair or your head/face in general.  One, bend your head away from your injured arm, this reduces the angle your injured arm needs to bend to in order to reach your head.  Or two, bend over with your head pointed towards the floor (like you’re trying to touch your toes), apparently with gravity pulling from that direction it puts less stress on the broken bone, I found this upside down position MUCH less painful to work from for dealing with my hair.

This post was originally written 3 weeks after my original injury.  I will update and add on as things happen!

Update 1:

At 4 weeks on the dot I noticed I had a slightly wider range of motion, pain free, than I had previously.  I was able to use two hands to put up my hair without having to resort to tricks to manage it.  I’m also in less overall discomfort.  I still can’t straighten the joint fully, bend it fully, or put to much pressure on when its mostly bent or mostly straight, but its noticeably better than it was.

I saw the Ortho specialist at the 5 week mark, he was happy with the progress, but agreed that its not fully healed.  Followup in 4 weeks, continue with with I’m doing.  So much for having two hands to get the garden in!

Update 2:

At the same time that I was able to start doing my hair with two hands I was also able to touch my fingers to my face, ie-feed myself with my right hand.  However I quickly discovered that I still can’t put something in the palm of my hand and get it to my mouth (like, taking pills).  This hasn’t changed, but yesterday I discovered that if I turn my palm away from my face I can not only touch the back of the palm to my face, I can touch the back of my wrist to my face.  Interesting how much the angle everything is turned at makes a difference!

Update 3:

At seven weeks.  I can now take pills with my right hand.  I still have to be carefull of the position I sleep in, but I no longer need the pillow to prop my arm up on.  Still don’t have full range of motion back, but its getting better, almost daily improvement.

Update 4: at 9 weeks, my followup with the ortho doc, the bone is healed, now to fix my range of motion problems and re-strengthen the arm since it hasn’t been used much.  The lack of full extension may be at least partially my own fault.  For the first several weeks attempting to let the arm hang “normally” or loosely hurt, ALOT.  So I got into the habit of carrying the arm bent.  I’ve been slowly forcing myself to carry it relaxed, and it does feel like my range of motion is improving, we’ll see I guess