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 FracturesAn 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 FractureA 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 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:
- 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).
- 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.
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.
- 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.