Radial Head Avascular Necrosis After Fracture - Orthopedics

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Radial head avascular necrosis (AVN) is a condition that can occur after a fracture, particularly in the case of a comminuted fracture of the radial head. In your situation, where a fragment of the radial head has not healed after nine months, there is a concern for avascular necrosis, which is the death of bone tissue due to a lack of blood supply.
When a fracture occurs, especially in the radial head, the blood supply to the area can be compromised. If the blood flow is not restored, the bone may begin to die, leading to AVN. This condition can result in pain, loss of function, and eventually arthritis in the affected joint. The risk of AVN increases with the severity of the fracture, the degree of displacement, and the presence of any associated injuries.

In your case, since you mentioned that one fragment of the radial head has not healed after nine months, it is crucial to monitor the situation closely. The fact that it has not healed could indicate that the blood supply to that fragment is insufficient, which raises the risk of necrosis. Symptoms of AVN may include persistent pain, swelling, and decreased range of motion in the elbow joint.

To assess whether the non-healing fragment is undergoing avascular necrosis, your healthcare provider may recommend imaging studies such as X-rays or MRI. An MRI is particularly useful as it can detect changes in the bone marrow that indicate AVN before significant bone collapse occurs.
If avascular necrosis is confirmed, treatment options may vary depending on the extent of the necrosis and the symptoms you are experiencing. In some cases, conservative management such as physical therapy, pain management, and activity modification may be sufficient. However, if the necrosis is significant and causing functional impairment, surgical options may be considered. These could include procedures to remove the necrotic bone, bone grafting, or even joint replacement in severe cases.

In summary, it is essential to follow up with your healthcare provider regarding the status of the non-healing fragment of the radial head. Regular monitoring and appropriate imaging can help determine if avascular necrosis is developing. Early intervention can significantly impact the outcome and help preserve joint function. If you experience worsening symptoms or new pain, do not hesitate to seek medical attention promptly.