He was hit by a pitch and fractured his elbow just when colleges wanted to see him pitch

Q. My son is an elite, 18-year-old right-handed baseball player whose right elbow was injured last week. He was hit by a pitch while batting.

The X-rays and an MRI revealed a radial head fracture that was not out of place. The doctor said he did not need a cast but he had to be careful. The doctor also said that my son should try to keep his elbow moving.

I am confused as I thought fractures needed a cast to heal as well as immobilization. Does this sound right and any idea when my son can play again? This summer, colleges are looking at him for a potential scholarship.

A. The radial head is the smaller of the three bones in the elbow; it’s important for rotation and contributes to stability.

Radial head fractures that are out of place require surgery, which can be complicated and may result in loss of elbow straightening and forearm rotation. This could be devastating for a throwing athlete.

Fortunately, it appears that your son’s fracture is in good alignment.

Although most fractures heal with immobilization in a cast or a brace, radial head fractures that are in place are best treated with careful active range of motion exercises to prevent permanent stiffness. This is particularly true in his throwing arm.

It is important that your son be followed closely by his orthopedic surgeon to make certain the fracture does not displace and that he regains good motion and function. Best guess is that he will be sidelined for two months.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net