The clinical progress of 80 adults with fractures of the radial head was followed prospectively. Early active movement of the elbow and forearm was encouraged in all patients. Better functional results were achieved by the study group than by retrospective controls in whom active movement was delayed. Aspiration of the elbow and instillation of local anaesthetic were carried out in a randomly selected half of the patients. This afforded relief of pain in 92 per cent and made early movement more comfortable. The fracture was more common in women. Functional recovery was best in younger patients and was closely related to the severity of the fracture.