The radius and ulna, two bones that make up the forearm, are found on the thumb and pinky sides, respectively. The radius and ulna are the two bones that make up your forearm. Most adult forearm fractures involve both broken bones. In the middle of the forearm, at the top (proximal) end closest to the elbow, or at the farthest (distal) end closest to the wrist, forearm fractures are possible. The middle segments of the radius and ulna are the focus of this blog post.
Anatomy of Forearm
If you hold your arms at your side with your palms facing up, the ulna is the bone closest to your body and the radius is closest to your thumb. The ulna is larger at the elbow — it forms the point of your elbow — and the radius is larger at the wrist. The primary motion of the forearm is rotation: the ability to turn our palms up or down. The ulna stays still while the radius rotates around it. This is the motion used to turn a screwdriver or twist in a light bulb. Forearm fractures can affect your ability to rotate your arm, as well as bend and straighten the wrist and elbow.
Possible causes & impact of Forearm Fracture
- The most frequent cause of a broken arm is falling onto an outstretched hand or elbow.
- Direct hits and other sports-related injuries can result in all different kinds of arm fractures.
- During a car accident, bicycle accident, or other direct trauma, any of your arm bones may break.
- A broken arm in a child may be the result of abuse.
There are several ways forearm bones can break. The bone may only slightly crack or it may splinter into numerous pieces. The broken bone fragments may line up perfectly or they may be terribly misaligned. In some instances, the bone will fracture in a way that causes bone fragments to protrude through the skin or a wound to extend all the way to the broken bone. Due to the potential for infection, this is referred to as an open fracture and necessitates immediate medical attention.
Adults are more likely to break both bones during a forearm injury because breaking the radius or ulna in the middle of the bone requires a significant amount of force. When only one bone in the forearm is broken, it usually happens to be the ulna. This usually happens when your arm is raised in self-defense and you receive a direct blow to the outside of it.
In contrast, one bone may fracture while ligaments at the elbow or wrist are torn, causing the joint to dislocate in addition to the fracture. These injuries have specific names: Monteggia and Galleazi injuries. They are less frequent than breaking both bones.
Symptoms of Forearm Fracture
- Whenever you move your wrist or elbow, your arm hurts more.
- Discomfort or swelling in the hand, wrist, or forearm.
- An obvious anomaly, like a bent arm or wrist.
- Difficulty with normal arm movement or use.
- Numbness, bruises, or warmth in the wrist or forearm.
- Numbness in the hand.
Different types of Forearm Fractures
The radius bone at the wrist, the radius and ulna, and the ulna alone, are all possible locations for forearm fractures (near the elbow). Most frequently, ulna injuries are accompanied by fractures of the radius. Due to their proximity, when one bone sustains an injury, the other bone usually suffers as well.
Galeazzi fracture
Occurs when the radius fractures (breaks) separately from the ulna. When this takes place, the wrist-end of the ulna may dislocate.
Plastic deformation
Often has an impact on the radius or ulna. Adult bones are less elastic than growing bones in children. A child’s bone may deform (bow) under excessive force as opposed to actually breaking. After the force is released, this deformity is left behind.
Monteggia fracture
Affects both the radius and ulna. The ulna typically fractures and the elbow dislocates at the top of the radius.
Nightstick fracture
Occurs when the ulna separates from the radius and fractures. When kids fall to the ground and land on their elbows, the ulna is especially vulnerable because it can be felt from the tip of the elbow to the wrist.
Complications in Forearm Fractures
The prognosis for most arm fractures is very good if treated early. But complications can include:
Uneven growth
Because a child’s arm bones are still developing, a fracture in the growth plate, which is located near each end of a long bone, can impede that bone’s development.
Osteoarthritis
Years later, arthritis may develop in a joint due to fractures that extend there.
Stiffness
When a fracture in the upper arm bone needs to be immobilized, the range of motion in the elbow or shoulder may become painfully constrained.
Bone infection
A broken bone fragment that pokes through the skin runs the risk of coming into contact with bacteria that can infect you. This type of fracture must be treated right away.
Nerve or blood vessel injury
The jagged ends of the upper arm bone (humerus) can harm nearby nerves and blood vessels if it fractures into two or more pieces. If you experience numbness or circulation issues, you should seek immediate medical attention.
Compartment syndrome
The blood supply to a portion of the injured arm may be cut off by excessive swelling, resulting in pain and numbness. A medical emergency requiring surgery, compartment syndrome typically develops 24 to 48 hours after the injury.
Treatments for a Forearm Fracture
Nonoperative Treatments
For roughly four to six weeks, a cast can be used to treat an ulna fracture that is stable, straightforward, and isolated and was caused by a direct blow. In order to prevent the fracture from shifting and to ensure proper bone healing, your doctor will closely monitor your progress using X-rays. Weight bearing and lifting are prohibited during this time.
You will begin physical therapy with targeted exercises after the cast is taken off in order to regain full range of motion in your elbow, wrist, and forearm rotation. Based on how your fracture is healing, your doctor will gradually allow you to lift weights.
Surgical Treatments
The majority of forearm cases require surgery, which is typically carried out through one or two incisions made at various forearm levels and sides. Plates and screws are used to reduce the fractures and hold them together. Your forearm will be placed in a brief splint for comfort and security following surgery. After surgery, you won’t be able to lift anything heavy for six weeks.
Open reduction and internal fixation with plates and screws
The most typical surgical procedure to treat forearm fractures is this one. The doctor first reduces (repositions) the bone fragments into their normal alignment during this procedure. Special screws and metal plates attached to the outside of the bones hold the bones together.
Open reduction and internal fixation with rods
A specially crafted metal rod is inserted by the surgeon during this process through the marrow space in the middle of the bone.
External fixation
Using plates and screws and making large incisions may further harm the skin if the muscles, bone, and skin have already been severely damaged. Infection could result from this. An external fixator might be used to treat you in this situation. The surgeon inserts metal pins into the bone above and below the fracture site during this type of procedure. The bar outside the skin is where the pins and screws are attached. This apparatus serves as a stabilizing frame to maintain the bones in the right alignment for healing.
Conclusion
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