Forearm Fracture Treatment & Surgery
The best treatment for your forearm fracture depend on a number of factors, including age, past and present health, the severity of the fracture and history with other medications and treatments. Forearm fracture, which is a complete or partial break in one or both of the two bones in the forearm, occurs most commonly in children and the elderly.
Forearm Fracture Diagnosis
A forearm fracture can cause significant pain and visible deformity. If you have been involved in some sort of trauma and believe your forearm may be injured, it is important to seek immediate medical attention. In order to diagnose your injury, your doctor will ask you questions about past medical history and the recent trauma (if any), as well as perform a physical exam. Then, one of the following tests will be done to determine the extent of the injury:
- X-Ray (Radiograph) – This is the most common test performed to determine the extent of the injury. Electromagnetic radiation is sent through the arm to create an image of the bone structure. This will show which bones have been broken or displaced in the trauma, and if there are any pieces of bone that have come completely apart.
- Pulse Test – In some cases, the blood flow may be restricted by the breakage, causing the hand to lose circulation. The doctor will test the wrist to find the pulse and determine if blood is still flowing to this part of the body.
Nonsurgical Treatment for Forearm Fractures
In the majority of forearm fracture cases, surgery is required to ensure that both of the main bones, the radius and the ulna, return to normal function. However, most forearm fractures in children as well as adult forearm fractures that involve only the Ulna may be treated without surgery. These include immobilizing the arm with a cast or splint. If necessary, the doctor will guide the bones to realignment prior to placing the forearm in a cast.
Surgery for Forearm Fractures
In most cases, a forearm fracture necessitates surgery. The aim of most forearm fracture surgeries is to hold both bones in place so that they return to normal function. Without anatomic alignment of the radius and ulna, forearm rotation will be severely limited. . The vast majority of forearm fractures are treated in one of the following ways:
- Metal Plate and Screws – The most common surgical treatment uses metal plates and screws on both the ulna and radius to hold them in place as they heal. This helps to stabilize both bones so they can return to proper function. These plates and screws must be administered separately, so there are usually two incisions that must be made.
- Metal Rod – In rare cases, a metal rod is placed through the center of the bone. This rod must be designed specifically for the forearm in order to work; otherwise it could limit the rotational abilities of the bone. For this reason, this procedure is not performed as often.
- External Rotation – When there is significant damage to the skin and tissue surrounding the bone, making more incisions may only cause further damage. In this case, external plates are screwed in to repair the bone without damage.
Forearm Fracture Research
Much of the research surrounding forearm fractures has to do with children, as they are the ones who experience this type of fracture most often. One of the concerns is treating this oddly shaped bone as it continues to grow. Because surgery is needed in many cases to properly heal this bone, placing plates and screws on a growing body can lead to other issues.
Recently, a study was conducted by Dirk W. Summerfeldt, MD in Hamburg, Germany. This study focused on the idea that in children, using an elastic IM nail to repair the bone may allow the bone to remain stable, but also give it room to grow naturally. These were only done in distal fractures, or the fractures surrounding the lower part of the forearm. In the study, doctors calculated whether or not the elastic nails were a better fit for the child. They tested 122 children and in the end, they had successful repair without complications in all but three cases. This number is higher than the success rate without complications using more traditional approaches for correcting distal fractures in children.
The forearm contains two bones, making repair more complex. As research on treatments continues to advance, children are expected to be able to regain their mobility faster and have fewer complications as a result of surgery.
As research on treatment methods is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.
The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York performs Forearm Fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.
To learn more about forearm fractures, visit the American Academy of Orthopaedic Surgeons (AAOS).