Forearm fractures are breaks or cracks in one or both bones in the forearm – the radius and the ulna.

Common Symptoms

• Immediate and severe pain in the forearm
• Obvious deformity or shortening of the forearm or appearing bent
• Swelling in the forearm, bruising, or pain when rotating or turning the forearm

Cause & Anatomy

Causes of Forearm Fractures:

• Falls onto an outstretched arm or directly onto the forearm.
• Direct blows or impacts to the forearm.
• Motor vehicle accidents, sports injuries.

Types of Forearm Fractures:

• Single bone fractures: Fracture of only the radius or only the ulna bone.
• Both bone fractures: Fractures occurring in both the radius and ulna bones simultaneously. These can be:
  • Galeazzi fracture: Displaced fracture of the radius combined with dislocation of the ulna at the wrist joint.
  • Monteggia fracture: Fracture of the ulna combined with dislocation of the radius bone at the elbow joint. This is a severe injury.
  • Growth plate fractures: Fractures that occur at or across the growth plates in children, commonly in the radius near the wrist.
  • Greenstick fractures: The bone cracks but does not break completely, causing it to bend.
  • Torus (buckle) fractures: Compression of the bone on one side causing the other side to buckle outwards, without breaking the bone.

Diagnosis

X-rays are typically ordered to confirm the diagnosis and assess the extent and location of the fracture. It may require looking at the wrist, the forearm, and the elbow.

What is the treatment for Forearm Fractures?

• Nonsurgical: Casting or splinting for simple, stable isolated fractures may be possible and is more often an option in children.
• Surgical: Open reduction and internal fixation with plates and screws is commonly required for displaced, unstable or complex fractures, especially in adults. This restores alignment.

Surgery

The main surgical treatment for forearm fractures (fractures of the radius and ulna bones) is open reduction and internal fixation (ORIF). Here are the key points about this surgery:

• It involves making an incision over the fracture site to expose the broken bones.
• The bone fragments are repositioned (reduced) into their proper alignment.
• The fractures are then fixed internally using plates and screws secured to the outer surface of the bones. This holds the bones in their correct position to allow healing.

Rehabilitation

The rehabilitation for forearm fractures after surgery typically involves the following but will vary based on the severity of the fracture and how it was fixed.

Initial Immobilization: A splint or removable brace is applied for 1-2 weeks after surgery to protect the surgical fixation and allow initial healing. The splint is then removed to begin range-of-motion exercises.

Range-of-Motion Exercises: Active and active-assisted range-of-motion exercises for the shoulder, elbow, wrist, and fingers are initiated as soon as pain and swelling subside, usually around 1-2 weeks post-op. Pronation and supination (rotation) exercises of the forearm are also started early to prevent stiffness.

Physical/Occupational Therapy: Many patients are referred to physical or occupational therapy 2-4 weeks after surgery to help regain range of motion, strength, and function. Therapy focuses on stretching, strengthening exercises, and activities to improve dexterity and functional use of the arm and hand.

A gradual return to activities is allowed as the bone heals.

FAQ’s

What if I suspect I have a forearm fracture?
Seek an evaluation from a hand surgeon as soon as possible.