A radial ulnar fracture is a fracture of the two bones that make up your forearm, the radius and the ulna. A fracture to both bones at the same time is most common towards the distal heads of each bone, closest to your wrist. A radial ulnar fracture is most commonly caused by a traumatic impact of your wrist, usually during a fall with your arm extended. This type of fracture is a medical emergency: seek medical attention immediately if a fracture is suspected. You can typically expect your forearm to be immobilized in a cast for six to eight weeks following the injury. Afterwords, it is important to undergo physical therapy to rehabilitate the muscles and ligaments that have atrophied, or lost size and strength, during immobilization.
In the first few days after a radial ulnar fracture, your doctor may place your arm in a sling. This will keep your arm immobilized and allow for swelling to reduce before your arm can be cast. The physical therapy treatment is used at this time is typically cryotherapy. Cryotherapy, or cold treatment, consists of placing ice or cold packs over the affected area of your arm to reduce inflammation. Inflammation hinders your body's natural ability to begin the healing process. After several days of cryotherapy, the swelling around your fracture may subside enough to allow a hard cast to be placed on your arm.
Range of Motion Exercise
After about six to eight weeks in a hard cast, your bones should be sufficiently healed. However, due to several months of immobility, the ligaments that cross your wrist may become stiff, thereby limiting your range of motion. A physical therapist may begin therapy by providing you with range of motion exercises. The purpose of these exercises are to increase your range of motion at your wrist joint. Your physical therapist may provide you with passive and active flexibility exercises designed to slowly increase your ability to move your wrist through its normal range of motion.
Muscle Strengthening Exercise
As your ligaments regain their flexibility and your range of motion at your wrist joint increases, you may begin muscle strengthening exercises. After months of non-use, your forearm and wrist muscles will loose both size and strength. Every muscle that crosses your wrist joint should be strengthened to increase the stability of your joint capsule. Your physical therapist will direct you through the proper strengthening exercises that are specific to your needs.
Deep Tissue Massage
During the healing process, scar tissue forms in ligament connections around your wrist. Scar tissue formation is a normal response to injury, but it can cause distortion and contribute to wrist pain and stiffness. Deep tissue massage is a type of physical therapy treatment that is designed to break up the fibrous scar tissue deposits around your wrist. This will help the scar tissue realign with your wrist ligaments, thereby reducing their contribution to stiffness and pain.
- American Academy of Orthopaedic Surgeons: Distal Radius Fracture
- "Therapeutic Exercise: Foundations and Techniques (5th edition)"; Carolyn Kisner and Lynn Colby; 2007