Forearm Fractures

The forearm is made up of two bones, the radius, which is the strongest bone, and the ulna, the stabilizing bone.  In adults, when one bone is broken, the other bone is broken, too. Fractures of the forearm can occur distal or near the wrist end of the bone.  It can also occur in the middle or near the elbow at the proximal end of the bone.  Each is treated differently so this article refers to only mid-shaft fractures.

If you hold your hand palms up, your radius us closest to your thumb and your ulna is on the side of your small finger.  The wrist is the larger of the two bones.  The ulna is larger at the elbow and forms the point of the elbow.  The radius is larger at the wrist.

The forearm mainly rotates to turn the palm up or down.  The ulna remains still while the radius rotates around it.  Forearm fractures can affect one’s ability to rotate the arm as well as bending and straightening of the wrist and elbow.

The forearm bones are able to break in several ways.  The bone can crack slightly or can fracture into many pieces.  The broken pieces of bone can be in place or can be a far ways out of place.  The bone fragments can break through the skin, causing an open fracture. Open fractures are particularly dangerous because they can lead to infection in the bone.

There is generally a strong force used to break a radius or ulna in the middle of the bone so it is more common for both bones to break together.  If one bone is broken, it is usually the ulna in a situation where a person has their arm raised in self-defense.  The ulna is the bone closest to the attacker.

The main causes of a midshaft forearm fractureinclude a direct blow to the forearm, a fall on an outstretched hand, such as in sports or a fall from a height, or an automobile or motorcycle accident.

The main symptoms of a forearm fracture are immediate pain and an obvious deformity of the forearm.   The forearm may seem to be shorter than the other arm.  You’ll need to support the injured arm with your other hand.  There may be swelling and bruising of the forearm plus an inability to rotate the arm.  There can be  numbness or weakness of the wrist or fingers depending on how much nerve damage there is.

Most patients will go to the emergency room or urgent care for evaluation and treatment of the injury.  The doctor will take a history and physical examination, trying to understand the circumstances of the injury.  He will want to know if you fell and how far you fell or if you were struck by a force.  He will want to know about chronic illnesses, such as diabetes, that you might have and any medication you take.

The doctor will examine the skin to see if there are any cuts from the injury or if bone fragments are sticking out from the injury.  This leads to a risk of infection in the bone and in the tissues.  He will check for a pulse in the wrist to make sure there isn’t a vascular injury to a major artery.  He will look for areas of tenderness and will ask you to move your fingers to make sure they move.  The rest of your extremity will be evaluated to make sure there are no other injuries.  He will then do an x-ray to see the relationship between the various bony fragments.

The treatment of a forearm fracture depends on putting the forearm bones back in their proper positions and must be prevented from moving out of place until they are healed.

For immediate treatment, such as in the emergency room, the doctor might try to temporarily put the bones in place in a procedure called reduction.  The doctor will give you pain medications for this procedure.   The doctor will then apply a plaster splint and ace wrap it to your forearm so that your bones will stay in position.  A sling will be applied as well to the arm so the arm is not kept dependent.

If one bone is broken and it isn’t out of place, a cast may be used to protect the arm until it heals.  X-rays will monitor the healing of the bones.

If both bones are broken or if there is an open fracture, then the fracture will be surgically healed.  Open fractures are healed immediately because of the risk for infection.  Antibiotics are given by IV in order to clean up any infection that might occur in an open fracture.  The patient may need a tetanus shot.  If the skin is unbroken, the doctor may decide to wait until the swelling has gone down in order to do surgery.

Open reduction and internal fixation is done with plates and screws.  This is the most common way to repair a forearm fracture.  Bone fragments are reduced and then held together with long plates that have screws to attach them to the bone. For More Detail Visit: Australian Medical Negligence Lawyers Solicitors

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