Rheumatoid arthritis Part 1, case based approach with application of the late...
Forearm Fracture
1. Forearm Fracture
Information about fractures of the forearm bones
A forearm fracture occurs when there is a fracture of one or both of the bones of the
forearm. The two bones of the forearm are the radius and the ulna. Both bones are
important for proper motion of the elbow and wrist joints, and both bones serve as
important attachments to muscles of the upper extremity.
How do forearm fractures occur?
The most common types of fractures occur due to a fall onto the hand, or a direct
blow to the forearm (commonly seen in altercations, sports injuries, and car
accidents). Symptoms of a forearm fracture include pain, swelling, and deformity of
the forearm. Diagnosis of a forearm fracture can be made with a proper physical
examination and x-ray studies.
What are the types of forearm fractures?
Fractures of the forearm bones that occur around the elbow (radial head fractures
and olecranon fractures) and those that occur around the wrist (wrist fractures), are
considered elsewhere.
Discussed here are radial shaft fractures, ulnar shaft fractures, and fractures of both
forearm bones.
Radial Shaft Fractures
An isolated fracture of the radial shaft is an unusual injury. More commonly,
fractures of the radial shaft are associated with injury to the ulna (see 'both bones
forearm fracture' below) or injury to one of the joints around the wrist (Galeazzi
fracture).
When an isolated radial shaft fracture occurs, it commonly requires surgery unless
the fracture is non-displaced. If the fracture is out of position, then forearm rotation
could be limited unless the fracture is realigned. For this reason, most radial shaft
fractures are treated with surgery to realign and hold the bones in proper position.
Both Bones Forearm Fracture
A both bones fracture is an injury that almost always requires surgery in an adult
patient. Without surgery, the forearm is generally unstable and there is no ability to
cast this type of fracture in a proper orientation.
How is surgery done in the treatment of a both bones forearm fracture?
Both bones forearm fractures are most commonly treated by placing a metal plate
and screws on both the radius and ulna bones. These bones must each be
approached through a separate incision; therefore you will have two incisions on
your forearm. Some surgeons will use a rod within the bone to maintain the position
2. of the bone, but this cannot be done in fractures where rotational stability is an
issue. Therefore, most both bones forearm fractures are treated with a plate and
screws.
What are the complications associated with a both bones forearm
fracture?
The most common complications of these fractures include:
o Decreased Motion
Limited motion is common after the treatment of forearm fractures.
Motion can be limited in the elbow and wrist joints, but is most
commonly noticed as a limitation of forearm rotation (i.e. opening a jar
or turning a door handle).
o Non-Healing Fracture
The bones of the forearm can have inadequate healing leading to
persistent pain. This is especially true with forearm fractures where
bone is lost because of the type of fracture (i.e. many small pieces) or
open fractures. Repeat surgery for bone grafting may be necessary in
these cases.
o Infection
Infection can occur after any surgical procedure. When an infection
occurs after fixation of a forearm fracture, the metal plate and screws
may require removal in order to cure the infection.
o Painful Hardware
The metal implants used during surgery may be felt under the skin, and
they may be painful. If they do cause discomfort they can be removed,
usually at least a year after surgery.