Forearm Fracture Treatment
The forearm consists of two very important bones: the radius and the ulna. The radius is the larger forearm bone on the same side of the arm as the thumb, and the ulna is the smaller bone on the opposite side. As you can probably imagine, immediate treatment of a broken arm is crucial. Because we use these parts of our body every day, we want to ensure as smooth a recovery as possible. Even for a small hairline ulna fracture, it’s important not to put off treatment.
At SPORT Orthopedics + Physical Therapy, we offer a wide range of treatment options for all sorts of broken bones. In many cases of forearm fractures in adults, both ulna fractures and radius fractures are present. Thus, our Dallas orthopedic specialists pride themselves on their extensive treatment knowledge. If you suffered an ulna fracture, we’re here to help. To schedule an appointment with us, please call our office at 469-200-2832 today, or fill out our online intake form.
What Is an Ulna Fracture?
A fracture of the ulna affects the forearm bone on the same side as your pinky. This bone narrows toward the hand and widens toward the elbow, actually forming the elbow “point.” Fractures of this bone can occur at any point along the bone, and have different descriptors depending on the location. Fractures near the wrist are distal fractures. Those in the middle of the bone or near the elbow are proximal fractures. As we stated previously, it is common to fracture both the radius and the ulna at the same time.
Bones in the forearm can shatter in a variety of ways. The bone might either break slightly or shatter into many fragments. Any fractured bone pieces may be perfectly aligned or may be out of place. The bone may shatter in such a way that bone pieces protrude through the skin or a wound penetrates down to the damaged bone in some situations. Because of the potential for infection, this is an open fracture, which requires rapid medical treatment.
Adults are more likely to shatter both bones following a forearm injury due to the high force necessary to break the radius or ulna in the center of the bone. Usually, if only one bone breaks, it is the ulna. The break often results from a direct blow to the arm, as when people raise their arm to defend themselves.
Symptoms of an Ulna Fracture
As with many breaks, the first symptom is usually pain. In cases where both the radius and the ulna fracture, the arm tends to deform. The arm either appears shorter than the other arm or bent in an unnatural way. Many people need to support the broken arm with their other hand in order to hold it up. Below, we list other notable symptoms associated with an ulna fracture.
- Difficulty or inability to rotate the arm
- Weakness or numbness in the wrist or fingers
How to Diagnose an Ulna Fracture?Initial treatment usually begins when people visit the emergency room or an urgent care center. First, explain to your doctor how the injury occurred. Did you fall off of something? How far did you fall? Additionally, let your doctor know if you suffered other injuries. Also explain other medical issues you might have, and outline the medications you take. Once your doctor has enough information about your medical history and symptoms, they will perform an examination. During the examination, they do the following.
- Examine your skin to determine whether the damage has caused any cuts. Lacerations can be caused by bone particles breaking through the skin. As a result, there is a higher chance of infection.
- Feel your arm from end to end to see if there are any additional sensitive spots. This might be a sign of more fractured bones or injuries.
- Check your wrist pulse to ensure that blood gets through your forearm to your hand.
- Examine your fingers and wrist to check whether you can move them and feel things with them. Nerves can be damaged at the same time that a bone is shattered, resulting in numbness and weakness in the hands and wrists.
- The most popular and commonly used diagnostic imaging method is X-rays. X-rays can reveal if a bone is fractured and whether it has been displaced. They can also indicate how many fractured bones are present.
Types of Forearm FracturesFractures of one or both forearm bones are possible. Specific fractures, Galeazzi and Monteggia, occur when the bones break at separate levels and the joints at the wrist or elbow sustain damage.
- Galeazzi fracture: This is a displaced radius fracture with a dislocated ulna at the wrist joint.
- Monteggia fracture: This is an ulna fracture with a radius dislocation at the elbow joint.
What Causes an Ulna Fracture?Forearm fractures have three common causes that make up the bulk of the cases we see.
- Direct blows to the forearm
- A fall on an outstretched arm, usually while playing sports or falling from a height
- Motorcycle or motor vehicle accidents
Ulna Fracture TreatmentBroken bones are treated in the same way as other shattered bones: the broken parts must be repositioned and kept from moving until they mend. It’s critical that the radius and ulna are adequately stabilized because they rely on each other for support. If the bones are not precisely aligned throughout the healing process, subsequent wrist and elbow mobility issues may occur. While many adult forearm fractures require surgery to align and stabilize the bones, this is not always the immediate treatment.
Immediate CareDepending on how far the parts are out of position, the doctor may try to realign them temporarily while you’re in the emergency room. The precise name for the process in which the doctor puts the parts into position is “reduction.” This isn’t a surgical operation. Medication will help you manage your pain. Your doctor then will put a splint (similar to a cast) on your forearm and equip you with a sling to hold your arm in place. A splint, unlike a complete cast, may be tightened or relaxed and allows for safe swelling. Controlling the mobility of a fractured bone is critical. Moving a fractured bone can result in further injury to the bone, adjacent blood vessels, nerves, and other structures. Additional urgent care will include the use of ice to decrease swelling and the administration of pain medication.
Nonsurgical TreatmentIf you only fracture one bone and it is not displaced, a cast or brace is likely sufficient. Your doctor will carefully monitor your fracture’s healing and schedule regular check-ups for X-rays. If this is not enough, your doctor might recommend surgery.
SurgerySurgery is generally ideal when someone breaks both forearm bones, or if the bones puncture the skin. Open fractures are generally scheduled for surgery right away due to the increased risk of infection. In the emergency room, patients are usually administered antibiotics through an IV, and may be given a tetanus injection. The cuts from the injury will be properly cleaned out during surgery. The fractured bones are usually repaired at the same time. If the skin around the fracture has not been broken, your doctor may advise you to wait until the swelling has subsided before undergoing surgery. Swelling can be reduced by immobilizing and elevating your arm for a few days. It also provides an opportunity for stretched skin to heal.
Types of Surgical Repair
- Open reduction and internal fixation (plates and screws): This is the most frequent surgical procedure for treating forearm fractures. The bone pieces are initially realigned (reduced) into their natural alignment during this operation. Special screws and metal plates connected to the bone’s exterior surface hold them together.
- Open reduction and internal fixation (rods): A specifically constructed metal rod is introduced into the marrow area in the middle of the bone during this surgery.
- External fixation: If the skin and bone have been badly injured, plates and screws, as well as extensive incisions, may further harm the skin. This might lead to infection. An external fixator may be used in this situation. Metal pins or screws are inserted into the bone above and below the fracture site in this procedure. Outside the skin, the pins and screws are connected to a bar. This device is a stabilizing frame that keeps the bones in place so they can recover properly.
Complications in Forearm Fracture TreatmentSometimes, forearm fractures cause significant injury to the surrounding tissue, leading to complications.
- Broken bones frequently have sharp edges that can slash or tear nearby blood vessels or nerves.
- Acute compartment syndrome is a disease in which the swelling cuts off blood flow to the hand and forearm. It results from excessive bleeding and swelling soon after an injury. It usually happens within 24 to 48 hours of the accident and produces excruciating agony when the fingers are moved. When compartment syndrome occurs, it can cause loss of feeling and function, and it necessitates immediate surgery. To relieve pressure and enable blood to return, the skin and muscle covers are opened and left open in such instances.
- An open fracture exposes the bone to the elements. The bone might get infected even after thorough surgical cleansing of the bone and muscle. Bone infection is tough to cure and frequently necessitates numerous operations as well as long-term antibiotic treatment.
Surgical ComplicationsEvery operation comes with its own set of hazards. If your doctor suggests surgery, it means he or she believes the potential advantages exceed the risks.
- Infection: Any surgery comes with the risk of infection.
- Blood vessels or nerve damage: Although a minor risk, it is possible to damage the nerves or blood vessels. If you have persistent numbness or tingling in the fingers, speak to your doctor right away.
- Synostosis: This is a rare complication which decreases the range of motion of the bones.
- Nonunion: While surgery does help, it does not guarantee healing. Sometimes, fractures pull apart, or the hardware within the arm shifts or breaks.