Three hundred eighty-seven cases of isolated fractures of the radial head are reviewed, that were treated over a 20-year period by the authors without operative intervention. Mason types I, II, and III were all included in this group. Excellent and good results were usually obtained. Seventeen radial head fractures were excised during the same 20 years because of severely displaced and/or loose fracture fragments. Roentgenographic and physical examination were the criteria for surgery rather than any specific classifications. The cooperation of the patient with early range of motion exercises was the major factor in obtaining excellent or good results with this injury.