What are forearm fractures?
The forearm has 2 cylindrical bones, the radius and ulna, that are parallel with each other and join the elbow to the wrist. These bone may be broken or fractured at any point along these bones. The fracture may occur in just one bone, one bone with the other bone dislocated at the elbow or wrist, or in both bones.
These bones are different in children as compared to adults. Children have growth plates at the ends of bones that can become injured leading to impaired or abnormal growth. The makeup of the bone in kids is much more elastic leading to more of a bending injury leading to a fracture like breaking a twig as compared to the adult that is usually more splintered. In children, the fracture not only healed quicker but also has tremendous ability to correct a deformity with remaining growth in the limb as compared to the adult that must be put back in place more exact with a greater need for surgical fixation of plates, screws or wires.
What causes forearm fractures?
Forearm fractures can occur from a fall on an outstretched upper extremity, a torquing or twisting injury, or a direct blow.
Contact sports such as mixed martial arts or football are common. A fall from playground equipment and unfortunately child abuse are causes in children.
What are the symptoms of forearm fractures?
A history of the mechanism of injury will reval usually a direct blow to the forearm, a fall on an outstretched upper extremity, or a twisting or torquing injury. There is immediate pain, swelling, bruising and deformity. In severe cases, there may be loss of feeling or circulation in the hand. In some, the bone ends may actually come through the skin.
How to diagnose forearm fractures?
In addition to a careful history of the symptoms described above, an examination will reveal:
- Localized tenderness, swelling and bruising in the forearm.
- Forearm deformity in displaced and angulated fractures
- Limited joint movement
- Tense forearm compartments with excessive bleeding around the fracture
- Loss of sensation or loss of circulation with a pale hand and absent pulse in severe cases
Additional important tests:
- X-rays of the forearm will usually reveal the fracture
- CT scan: in cases where a joint may be involved to provide a better view
- MRI: If associated ligament or cartilage injuries to the adjacent joints are suspected
Non-surgical treatment of forearm fractures:
In children, depending on the age of the child, location of the fracture and the degree of separation and angulation, usually, the fracture can be treated as is and placed in a cast for 4-6 weeks. In some, the fracture or break needs to be more properly aligned and the child will be sedated and the bone put back in position and then placed in a cast.
In adults, occasionally the fracture is partial or without separation and normally aligned. In these a cast will be adequate with close followup to ensure that the fracture alignment remains acceptable.
Surgical treatment of forearm fractures:
In children, rarely surgery is necessary to open the fracture and put the bones in place and possibly add pins temporarily.
In adults, surgery is usually necessary to place the fracture into proper alignment and then to surgically fix the fractures with plates and screws. Then after surgery a cast is applied for approximately 6 weeks while healing occurs.
In cases where there is excessive bleeding, loss of circulation, nerve compression, or the bone comes through the skin, surgery is usually indicated.
How can Dr. Knight help you with forearm fractures?
Dr. Knight has years of experience in the treatment of catastrophic upper extremity injuries, particularly forearm fractures. Since this condition is painful, urgent treatment is necessary. Dr. Knight will expedite your treatment on the same day it is needed and provide at least temporary support of the fracture until definitive surgery can be performed. If surgery is needed, he will use the latest techniques and equipment to restore the forearm fractures to their original position.
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