Forearm Fracture Treatment | Forearm Bone Fracture Surgery

There are two main bones in the forearm, namely the radius and the ulna. The ulna is considered as the stabilizing or the stationary bone, which the radius supports in order for the hand to move. Forearm fractures are so common that they almost amount for most of the limb fractures reported in hospitals. Of the many types of forearm fractures, wrist injuries are the ones commonly suffered by patients. Forearm fractures can either be the result of accidents or health-related issues such as osteoporosis. Forearm injuries are classified as being distal, proximal or middle arm injuries. They can also be closed (not fully fractured bones) or open (severely fractured bones) or both of the forearm bones injured.

Forearm Fracture Types

• Adult both-bone forearm injury is due to heavy indirect blows on the limbs like in the cases of vehicle accidents or falling from heights or other sport accidents. Considered as one of the most serious types of forearm fracture because the nerves near the fractured area can be affected, it can cause overall loss of hand function when not immediately treated.

• Paediatric both-bone forearm injury. This type of fracture can either be complete or incomplete. Incomplete fractures, also known as the greenstick types, usually occur when one of the forearm bones has been completely fractured. In the complete type, the bones can be un-displaced, overriding or only mildly displaced. The injury of pediatric fractures usually has something to do with indirect blows like falling on an outstretched hand.

• Radial Shaft injury. Also called as Galleazzi fractures, these are the solitary fractures that happen to one-third part of the radius bone. Its mechanism of injury is indirect blows like falling on an outstretched hand with the wrist pronated.

• Monteggia injury- considered as the opposite of Galleazzi fractures, this type of injury happens in one-third of the ulna bone with the radial head usually dislocated. The common mechanisms of this injury are accidents like falling on an outstretched arm with the elbow pronated and extended. It can also be caused by direct blows.

Diagnosis

There are general principles followed during diagnosis of forearm fractures. Basically, the treatment for fractures of children and adults are different because of their difference in their bone features. Children, for example, need special diagnosis because the bone growth of their radius and ulna are still continuing. Thus, considerations after the fracture has healed need to be done. The first physical exam the doctor will ask is the sensory function test. Here, the physician will check whether the limb and hand are still functioning properly and if any nerves were affected or not. After this is the motor function test. In this examination, the physician will ask the patient to make an ‘OK’ sign and also to extend his wrist and fingers against a force. The radial nerve and the ulnar nerve are the ones mostly examined here. After these tests, the elbow, forearm, and wrists will be checked for sensations of tenderness. Lastly, an x-ray will be conducted to properly analyze the extent of the fracture.

Causes

• Indirect forces-falling on an outstretched hand
• Stress and overuse- causes of stress fractures
• Muscle strains
• Nutritional deficiencies-calcium deficiency (osteoporosis)

Forearm Fracture Symptoms 

• Forearm deformity
• Swelling
• Pain
• Tenderness

Forearm Fracture Treatment

The treatment is dependent on the extent and type of fracture. For mild forearm injuries wherein the bones are not totally dislocated, these are treated with the use casts and slings for a couple of weeks. Both bones forearm injuries, on the other hand, mostly use surgeries in order to reconstruct the fragmented bones. Here, a metal plate is screwed into the ulna and radius bones. These tools will be attached by making two separate incisions on the affected hand. There are also cases when the surgeon needs to add a rod inside the bones in order to make sure that it keeps its position until the injury heals. This is not applicable, however, in cases wherein there is rotational stability of the bones.

Prevention

For people who have their forearm fractures because of calcium deficiency, the best prevention is to load up on this mineral and eat a balanced diet. Also, since most forearm fractures are the results of sport accidents, wearing protective padding while training is also a good prevention.

When to Call a Doctor

An individual who immediately experienced an indirect or direct blow to the arms or limbs should immediately see a doctor even though no feelings of pain are felt. There are cases when the fracture is so minute that it doesn’t cause any pain but worsens if stress is constantly applied on the bone. A forearm fracture that is ignored for a long time can cause problems like decreased limb movements and even internal infection.