Forearm Fractures

Understanding Injury, Treatment, and Recovery

Anatomy and Function

The forearm contains two bones – the radius and ulna – which work together to allow complex movements such as rotating the palm up or down (pronation and supination). The radius rotates around the ulna, and both are connected by a strong sheet of tissue called the interosseous membrane. This structure helps share force across the bones and supports wrist and elbow function.

Muscles in the forearm and upper arm influence fracture patterns. For example, the biceps and supinator rotate the forearm outward, while pronator muscles turn the palm downward. These forces can pull on fracture fragments and affect alignment.

Types of Forearm Fractures

In Children:

• Buckle (torus) fractures– compression causes the bone to bulge slightly.
• Greenstick fractures– one side of the bone bends and breaks, the other remains intact.
• Plastic deformation– the bone bends without breaking.

In Adults:

• Complete fractures– the bone breaks all the way through and often shifts out of place.
• Both-bone fractures– both radius and ulna are broken, often needing surgery.
• Named patterns:
  • Monteggia– ulna fracture with dislocated radial head.
  • Galeazzi– fracture of the radius with dislocation of the joint at the wrist.

Causes and Symptoms

Common causes include:

• Falls on an outstretched arm
• Sports injuries
• Road traffic accidents
• Direct blows (e.g., during contact sports or self-defence)

Symptoms:

• Sudden pain and swelling
• Visible deformity or shortening of the forearm
• Difficulty turning the hand or wrist
• Numbness or cold fingers if blood flow is affected

Diagnosis and Tests

• Physical examinationchecks for swelling, deformity, skin wounds (possible open fracture), nerve function, and circulation.
• X-raysin two directions (front and side) are used to assess alignment and check nearby joints.
• CT scansmay be used for complex breaks.
• MRImay be needed if soft tissues like ligaments or cartilage are involved.

Treatment Options

Non-surgical (conservative) treatment:

• Used mainly in children for stable or partial fractures.
• Involves closed reduction (gentle realignment) and application of a cast.
• The cast must be moulded correctly to keep the bones in place.

Surgical treatment:

• Required in most adult fractures and in children if bones are severely out of place.
• Common procedures include:
  • Plate and screw fixation– for rigid alignment and early movement.
  • Flexible intramedullary nails– used in growing children.
  • External fixation– sometimes used in open or high-energy injuries.
• After surgery, the arm may be protected in a splint or cast for several weeks.

Rehabilitation and Recovery

• Early movement is encouraged once the fracture is stable.
• Physiotherapy helps restore strength, flexibility, and movement patterns.
• Children usually heal in 6 to 10 weeks.
• Adults may require 3 to 6 months for full recovery.

Functional goals before return to sport or manual work:

• No pain
• Full range of motion
• Near-equal strength on both sides
• Good control of fine and gross movements

Complications to Watch For

• Nerve or blood vessel injury
• Compartment syndrome– dangerous pressure build-up in muscles
• Nonunion or delayed healing
• Malunion– bones heal in the wrong position
• Stiffnessor loss of forearm rotation
• Bone bridging between radius and ulna(synostosis), limiting motion

Key Differences: Children vs. Adults

Self-Check Quiz

1. What bones make up the forearm, and which one rotates?
2. What is a greenstick fracture?
3. Name two special forearm fracture-dislocation types.
4. What are typical symptoms of a forearm fracture?
5. Why might adults need surgery more often than children?
6. What are the goals of physiotherapy after fracture treatment?
7. What is one serious complication that can occur after a forearm injury?

Final Thoughts

Forearm fractures vary widely in severity. With prompt diagnosis and the right treatment—whether through a cast or surgery—most people recover good function. Children tend to recover quickly, while adults may need longer rehab and therapy. Stay alert for complications, follow your rehab plan carefully, and consult a specialist if symptoms do not improve.

Call to Action

If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk

Disclaimer

This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.

This page was last clinically updated in May 2025