WHAT YOU SHOULD KNOW
The two forearm bones, radius and ulna, have a special relationship with a shared joint at each end (elbow and wrist). The natural curve of the bones must be maintained or else full rotation of the forearm cannot be achieved.For all but absolutely non-displaced fractures surgical fixation is necessary. If much swelling accompanies the injury, a critical pressure can develop in the forearm that must be surgically released immediately.
MEDICAL HISTORY
Patients notice the unstable forearm and the need for splint support. Typical symptoms include pain, swelling, and deformity.
EXAMINATION
The doctor will evaluate for critical swelling that must be surgically released. If not an issue, each nerve and tendon is checked for function.
ADDITIONAL TESTS
Plain x-rays are sufficient. Only very rare fractures will show no displacement at all.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL | |
| CONSISTS OF | Splint then cast | Plates and screws, rarely rods |
| FEATURES | Runs from above the elbow to the hand | Plates and screws can be removed later if desired |
| ADVANTAGES | Avoids surgery | Restores normal anatomy |
| DISADVANTAGES | Only works if fracture is entirely non-displaced and very naturally stable | Significant incisions for plates, less if a rod is used |
RECOVERY
With the stability of plates and screws, no outside splinting is needed. The patient can return to functions much sooner with surgery than without. Light everyday activities can be done immediately after surgery. Once the bone heals around 8-10 weeks, the patient will need to do some therapy to regain forearm rotation and wrist motion. Contact sports do not usually resume until around 3-4 months after surgery.
