The patient with an occult radial head fracture can be managed with a sling for comfort with early range of motion as tolerated (within 24-48 hours).  If the pain is severe and range of motion is too painful, a posterior mold of the elbow can be placed.  Repeat films in 7-10 days should reveal the fracture line after the necrotic bone has reabsorbed.  Comminuted or displaced fractures should be immobilized and referred urgently to orthopedics.