A forearm is the part of the arm that lies between the wrist and elbow, and it consists of two bones, the radius and ulna. A break or crack in the bones near the wrist, the middle of the forearm, or near the elbow at the proximal end of the radius and ulna are referred as a forearm fracture. The bone(s) can either crack or break.
In some cases, a wound penetrates down to the broken bone as the bone fragments stick out through the skin. This is termed as an open fracture that requires immediate medical attention due to the risk of infection. Falling unto one’s arm could potentially result in a fracture to the forearm.
The most common signs of a forearm fracture are:
- Severe arm pain that gets worse with wrist or elbow movement
- Swelling and bruising in the forearm
- Noticeable deformities such as bent arm or wrist
- Numbness in the wrist
- Difficulty in arm movement
- A direct blow to the upper arm
- High-impact fall
- Severe twist of the upper arm
- Fall on an outstretched arm
- Extreme muscle contraction
Diagnosis and Treatment
X-rays and physical examinations are the most common diagnostic technique used for a forearm fracture. This type of fracture requires a careful examination of the skin around the elbow, forearm, and wrist to test the nerves and circulation. Finally, a X-ray is carried out to detect whether it is a case of broken bone or displacement.
The basic principle followed during the treatment is a rigid fixation, accurate anatomic reduction and early mobilization of the soft tissues. Some common forearm fracture treatments include cast immobilization and plate fixation. However, an operative method is used for most of the displaced fractures of the shafts of the radius and ulna. In some severe cases of adult forearm fractures, it may require surgery for successful healing. But the majority of the forearm fractures can be treated without surgery.
When just one bone is broken, and it is not out of place, surgery is not required. It can be treated with a cast or brace.
If both of the forearm bones are broken, or there is an open fracture, surgery is usually required. In some circumstances if a cut is observed in the skin near the broken bone or the bones are not lined up even in a cast, it needs surgery. Also, if the injury closer to the elbow and bones is not well aligned, surgery is required for treatment.
Complications From Forearm Fractures
Forearm fractures can lead to further injury and complications. The sharp end of a broken bone can cut or tear surrounding blood vessels or nerves. It may result in bleeding and swelling and lead to acute compartment syndrome.
It may cause loss of sensation and function, resulting in emergency surgery. The forearm fracture can become severe if the bone gets infected. This can be difficult to treat, and multiple surgeries and long-term antibiotics may be suggested for such complication. Also, if the growth plate at the end of the bone is disrupted due to the fracture, it can affect the bone development.
Fractures near the middle of the forearm may need a longer healing period while the crack near the wrist generally heals rapidly. After cast or splint, it is normal to have stiffness in the elbow or wrist. It needs a few weeks to get better, but in rare cases, physical therapy may be required to regain motion. It is better to avoid sports and physical activity for 4 to 6 weeks afterward to prevent the bone from re-breaking.