What is a forearm fracture?
A forearm fracture is a broken arm in the area between your elbow and wrist. Two bones make up the forearm—the radius and the ulna. The radius runs down the thumb side of the forearm. The ulna goes down the pinky side with the end of the bone forming the bony bump on the outside of your wrist. The upper end of the ulna forms the bony point of your elbow. The ulna is a slightly longer bone that always remains still. The radius pivots around the ulna to provide the rotation movements of the forearm.
Forearm fractures are very common in children. In fact, 40% of all childhood fractures involve the forearm. In most cases, children have a radius fracture in the area closest to the wrist. This is a distal radius fracture and is usually a break called a Colles fracture. In a Colles fracture, the broken radius end tilts the wrist upwards. Doctors often refer to distal radius fractures and Colles fractures as wrist fractures instead of forearm fractures. An ulna fracture is less common in children. In adults, forearm fractures usually involve both bones.
Like other types of broken bones, trauma is the main cause. However, diseases that affect the bones can increase the likelihood of breaking your forearm.
There are different types of breaks or fractures, which determine the symptoms you may have and the treatment you need. The most common types of bone fractures include:
Stable fracture with the broken bone ends remaining close together. These breaks usually heal with a cast or splint as the only treatment.
Displaced fracture with the ends of the broken bone out of place. Doctors must put the bones back together before casting so they will heal properly.
Comminuted fracture with the bone shattered into at least three pieces. Doctors must surgically reassemble the bones for proper healing.
Open or compound fracture with either a deep wound near the fracture or a piece of bone breaking through the skin. This fracture is a medical emergency because infection can set in quickly and lead to sepsis.
Forearm fractures can also involve joint structures, such as ligament and tendons. Stress fractures, or small cracks in the bone, are possible as well.
All broken bones require immediate medical attention. Seek immediate medical care (dial 911) if you, or someone you are with, may have a broken forearm. This is true even if you aren’t sure any bones are broken.
What are symptoms of a forearm fracture?
The symptoms of a forearm fracture, and their severity, will depend on the type of fracture and whether muscles or joint structures are involved.
Common symptoms of forearm fracture
The most common forearm fracture symptoms include:
Deformity of the forearm or wrist
Difficulty moving the forearm including rotating the arm or bending the elbow or wrist
Hearing a snapping, grinding or popping during the injury
Inability to tolerate the arm hanging down and the need to support it with the other hand
Pain, which can range from moderate tenderness to severe pain
Serious symptoms that might indicate a life-threatening condition
A forearm fracture is not life threatening itself. However, if the break is a compound fracture, infection can occur quickly and lead to life-threatening complications. Seek immediate medical care (call 911) if you, or someone you are with, have either of the following:
A piece of bone sticking out through the skin of the forearm or wrist
A potential fracture with a deep wound or trauma with open skin on the forearm or wrist
Finding medical care right away offers the best chance of successful healing without complications.
What causes a forearm fracture?
The most common cause of any broken bone, including the forearm, is trauma or injury. This includes a direct blow to the forearm, falling on the forearm, and falling with an outstretched arm. Stress fractures are also possible in the forearm, but are less common than in other bones. In this type of fracture, tiny cracks develop in the bone from repetitive stress or force on the bone. It is a type of overuse injury.
What are the risk factors for a forearm fracture?
A number of factors increase the risk of breaking the forearm including:
Being in a motor vehicle accident
Falling from a height
Having osteoporosis, which thins the bones and increases the risk of breaking them
Taking part in activities requiring repetitive motions or forces such as racquet sports
Playing contact sports such as basketball or football
Reducing your risk of a forearm fracture
Preventing broken bones is hard because they usually result from sudden accidents. However, you may be able to lower the chances of breaking your forearm with:
Calcium and vitamin D supplements as your doctor recommends to strengthen your bones
Protective sports equipment, such as wrist and forearm guards
Weight-bearing physical activity to strengthen your bones and the muscles that support and protect your bones and joints
Women who are near menopause and men approaching 70 years of age should talk with their doctor about osteoporosis. If you are at risk, your doctor may recommend a screening test. Early treatment can help prevent fractures and other complications.
How are forearm fractures treated?
Like other broken bones, treatment involves putting the bones back together if necessary and keeping them in place while they heal. This is usually a simple process. However, surgery is sometimes necessary due to the severity of the break. Treatment may include:
Cast immobilization, which is the most common treatment
External fixation, which involves surgically placing pins or screws into the bones. These attach to an external metal bar outside the skin. The bar stabilizes the bones during healing.
Open reduction and internal fixation, which surgically places pins, screws or plates directly to the surface of the bone. This hardware may remain in place permanently or your doctor will remove them later.
What are the potential complications of a forearm fracture?
There are potential complications of a forearm fracture including:
Infection after surgery or from a compound fracture. Even with cleaning of the fracture, it is possible to develop a bone infection
Malunion or nonunion, which occurs when the bones move out of place during healing. This is possible even with surgical fixation if the hardware shifts or breaks.
Nerve damage, which may persist
Synostosis, which is when bone tissue grows between the radius and ulna creating a bridge. This is a rare complication.
Diligently following your treatment plan is the best way to prevent these complications. Your treatment plan may include physical therapy to help you regain strength and function in your forearm. Recovery from a forearm fracture can take up to six months.