5 Things You Need to Know About Forearm Fractures

1. Forearm fractures are not as common as wrist fractures.
Typically, when you fall on an outstretched hand, you will suffer a distal radius (wrist) fracture, because the bone is weaker in that particular area. Sometimes, however, with enough force, the bone will break through the shaft where the cortex is thicker. Some common causes are skateboarding injuries and car accidents.
2. Get yourself to the emergency room!
Forearm fractures cause quite a bit of deformity, especially if both of the forearm bones (radius and ulna) are broken. If you suspect you have one of these fractures, seek medical attention immediately. This is typically a very unstable fracture pattern. There may be nerve damage, more so if the arm is allowed to flop around. At the emergency room, x-rays will be taken to see the exact pattern of your injury. You will receive a splint to stabilize the bones until definitive treatment can be administered. You should elevate the arm to reduce the swelling. A splint temporarily reduces the fracture, and helps to prevent further bleeding or swelling. You will still have pain, but you SHOULD feel better with the splint on. If you notice increasing pain despite the splint, seek medical attention immediately as well. Severe swelling can cut off the circulation to the forearm muscles (compartment syndrome). This is an orthopedic emergency which requires urgent surgery to release the pressure.
3. It is important to restore the radial bow.
The radius is the forearm bone that rotates across the ulna when you turn your palm up and down. There is a gentle curve, or bow, in the bone that allows this to happen. Fractures which disrupt the shape of the bone can limit or prevent forearm rotation, which can be very debilitating.
4. If you are younger, you may only need a cast.
Children have a higher capacity to heal and, more importantly, an increased ability to remodel. Bone grow in line with the forces they experience. Most of the forces on the forearm are axial, or in line with the bones. This gives them the ability to remodel, or "straighten" themselves out as they grow longer. However, this only happens while the growth plates are still open. Once the growth plates are fused, the bones can still heal themselves, but they won't grow any longer and won't correct any deformities. Because of this, most children with forearm fractures may be treated with a long arm cast, past the elbow. It usually takes about six weeks to heal.
5. If you are older, you generally will need surgery.
Galeazzi fractures (radial shaft fractures with involvement of the wrist joint) and both-bone (radius and ulna) forearm fractures are termed "fractures of necessity." This means that they are very unstable patterns of injury and necessitate surgery. These will not heal by themselves in a cast, because the muscles act as deforming forces at the fracture site. The only way to hold the bones still while they heal is with metal plates, screws or rods.