Middle Forearm Fractures

(Radius Fractures; Ulna Fractures)

ByDanielle Campagne, MD, University of California, San Francisco
Reviewed/Revised Dec 2022
VIEW PROFESSIONAL VERSION

Forearm fractures involve the middle of one or both of the forearm bones (radius and ulna).

  • Fractures of the middle forearm usually result from a direct impact during contact sports, falls, or defensive actions during an assault.

  • The fractured forearm is painful, swollen, tender, and sometimes deformed.

  • Doctors identify these fractures on x-rays.

  • Often, the bone fragments can be put back in place (reduced) by manipulation, then held in place by a splint or cast, but sometimes surgery is required.

Usually one of the bones (radius or ulna) in the forearm is broken from a direct blow. Doctors can usually put the pieces back in place and hold the bones in place with a splint or cast to heal. Rarely, one bone is broken and the other bone is also dislocated at the elbow or wrist. The combination of a fracture and dislocation usually requires surgery.

Fractures in the lower end of the forearm bones are considered wrist fractures and fractures in the top of the larger forearm bones, which are part of the elbow joint, are considered upper forearm fractures.

Symptoms

The fractured forearm is painful and swollen. There may also be bruising. Moving the forearm is typically painful, including extending the wrist or elbow.

Diagnosis

  • X-rays

(See also Diagnosis of Fractures.)

If people think they may have fractured their forearm, they should see a doctor as soon as possible.

Even though doctors can usually identify forearm fractures based on a physical examination, diagnosis includes x-rays taken to pinpoint the fracture's location and determine the extent of the injury.

Treatment

  • Realignment of the broken bones, with or without surgery

  • A splint or cast

The broken pieces are realigned or put back in place (called reduction). Depending on the type of fracture, reduction may or may not involve surgery. When possible, doctors move the pieces of bone back in place without surgery.  

For a simple fracture, if the bones are realigned without needing surgery, a splint is used to hold the bones in place. The person is then referred to an orthopedic surgeon for follow-up to monitor proper bone healing. Usually, the splint is removed, and a cast is applied. The cast is worn for about 4 to 6 weeks.

For more complicated fractures, reduction requires surgery, typically open reduction and internal fixation (ORIF). When ORIF is done, the broken bones are put back in place and held in place using a combination of metal wires, pins, screws, rods, and/or plates.  After surgery, the forearm will be put in a splint for about 6 weeks. 

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