CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

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CONSERVATIVE MANAGEMENTOF PROXIMAL RADIAL FRACTURES

Abdullah Faruk Uyanık

İstanbul Prof. Dr. Cemil Taşçıoğlu City Hospital, Department of Orthopedics and Traumatology, İstanbul, Türkiye

Uyanık AF. Conservative Management of Proximal Radial Fractures. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.189-193.

ABSTRACT

Radial proximal fractures are traumatic injuries affecting the elbow joint, and treatment approaches vary according to the type of fracture and degree of displacement. These fractures, classified according to the Modified Mason classification, are usually treated with conservative methods if they are minimally displaced and stable. Indications for conservative treatment include cases where displacement is less than 2 mm, non-comminuted fractures, absence of mechanical obstruction, and the patient’s general health status and preference play an important role. The treatment process begins with correct diagnosis and radiological evaluation. Closed reduction can be applied in cases where displacement occurs.

Immobilization is applied in the first stage of treatment. The elbow is fixed with a splint in a neutral position at 90 degrees of flexion and usually lasts for 10-14 days. Longer immobilization may increase the risk of joint stiffness. Early mobilization is initiated after immobilization to support joint movements and prevent muscle atrophy. NSAID use, ice application, and in some cases, a pain pump are recommended to manage pain.

During treatment, the stability of the fracture is monitored with control radiographs, while functional progression and complications are regularly evaluated. Possible complications include joint stiffness, malunion, pain and nonunion. These risks can be reduced with early motion and appropriate treatment. While conservative treatment provides successful results in correctly selected cases, it should not be forgotten that mechanical block or multi-fragmented fractures require surgical treatment.

Keywords: Radial proximal fractures; Conservative treatment; Modified mason classification; Immobilization; Early mobilization

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