Have you just been diagnosed with a forearm fracture and you have so many questions about treatment and recovery. Do not go anywhere, this article will answer most of your questions.
Based on my experience as a diagnostic radiographer and the scientific studies on this subject, I have written this article for you.
Happy reading!😀
Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏
Last updated: April 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
Basics:
The forearm is made up of two bones, the radius and ulna. Fractures of the forearm can occur at different levels near the wrist at the distal end of the bone, in the middle or near the elbow at the proximal end of the bone.
Forearm fractures can occur as a single (radius or ulna) or combined (both bones) break.
In my years of practice I have x-rayed so many broken forearms. Most patients I see always claim to have had a fall directly on their arm causing the fracture.
The most causes of forearm fractures occur as a direct or indirect injury to the forearm. This could be a fall, accident or during sports.
▶️What are the different types of forearm fractures?
When both bones are fractured at different levels and there is a joint injury at the wrist or elbow, these are described as:
- Galeazzi fracture: Most often a displaced fracture in the radius and a dislocation of the ulna at the wrist, where the radius and ulna come together.
- Monteggia fracture: Most often a fracture in the ulna and the top (head) of the radius is dislocated at the elbow joint.
▶️How can you tell if your forearm is fractured?
When you fall on your forearm the first signs and symptoms you will feel will be:
♦️Severe pain, which might increase with movement.
♦️ Swelling and bruising.
♦️️ Deformity, such as a bent arm or wrist.
♦️Inability to turn your arm from palm up to palm down or vice versa.
However, you will only confirm when you go to the emergency department for a proper examination.
▶️What do doctors do for a fractured forearm?
When you go to the doctor, your arm will be examined and before a doctor makes a full diagnosis and treatment plan, x-rays will be taken.
x-rays are usually enough to confirm if you have fractured your arm or not. Further imaging such as CT or MRI will be done for proper operation planning if needed.
X-ray image of a forearm fracture of both the radius and ulna
Forearm fracture treatment options
When you have had a forearm fracture treatment will depend on a few things:
⭕The type of fracture you have.
⭕Your age and health
Treatment could be conservative or surgical treatment.
if your fracture is stable, simple, and isolated fracture (secondary to a direct blow) for example ulna fractures then nonoperative method of treatment will be used.
A cast will be put on your forearm, and it usually stays on for about 4 to 6 weeks.
Your doctor will closely follow your progress with X-rays to assure no displacement of the fracture and proper bone healing.
During this time, you should not weight lift or bear to help ease pressure on the fractured site.
After removal of the cast, you will start physical therapy with specific exercises to regain full range of motion of your elbow and wrist and rotation of the forearm.
Your doctor will increasingly allow you to lift weights according to how your fracture is healing.
Surgical Treatments:
If your fracture is displaced badly usually the only option is surgery.
Your fracture will be reduced first and held together with plates and screws in theatre.
After surgery your forearm will be put in a short splint for comfort and protection.
X-ray images of forearm fracture pre and post operation
You will not be allowed to lift weight for six weeks after surgery.
▶️How long does it take for a fractured forearm to heal?
Healing of a broken arm will depend on the type of fracture you have got, your age and general health.
Topically the estimated time for healing is 3 to 8 weeks after treatment. But this will also depend on how bad the fracture was displaced and what kind of treatment you got.
For young children, the healing process may happen more quickly. For older adults or those who have an underlying health condition, such as diabetes, healing can take longer.
Note! injury to the wrist and elbow typically involve a lengthier recovery than anywhere else along the upper or forearm.
For complete healing and full strength it can take 12 weeks.
It can take two years for full strength to be restored and actively use your arm like before injury.
You should remember recovery is not always consistent or the same for every patient. same patients, factors like scar tissues, nerve damage and arthritis do delay healing.
▶️What affects the healing time of a bone?
🟩Elderly have a lower capacity for quick fracture healing compared to the young age.
🟩When you are overweight, it may take longer for your bones to heal.
🟩When you are malnourished or anaemic this could delay bone healing.
🟩Malnutrition, luck of vitamin D is associated with delayed bone healing.
🟩Smoking has been associated to delayed bone healing.
🟩Some medication eg NSAIDs has been associated to delayed bone healing when you take them for a long time.
🟩You are taking steroids and having health problems like diabetes.
Sources: sheen 2003
Use physical therapy to help you focus on strength and range of motion exercises to help with healing.
Here are some of the estimated timeline for a forearm healing provided by the physical therapy in the UK.
| Stages | Healing time frame |
| When you start feeling less pain. | A few days to a few weeks |
| Bone joining has progressed very well. | 4 to 3 months (shorter for children) |
| Swelling and bruising to disappear | A few days to a few weeks |
| You no longer need immobilisation | 6 weeks to 3 months |
| Using your arm to dress up and eat. | A few weeks to a few months |
| When to begin carrying weight with your fractured arm | 2 to 5 months |
| Begin all your physical and sports activities | 3 to 8 months |
Remember healing is different for everyone if you do not reach healing by these dates be patient your bone will heal completely with time.
▶️What are 3 things you can do to speed up the healing process?
You may be looking at the healing time frame and wondering what else you can do to speed up the healing time of a forearm fracture.
After intensive research, there is currently no drug or therapy that can help with speeding the healing time of your bone
however there are certain things you can do to avoid hindering the bone healing process which happens very well on its own.
What you should know! After breaking a bone, your body isolates the fracture site so that it’s protected, and floods the area with the nutrients that promote healing.
As healing progresses, your body begins to lay down new bone at the fracture site. This new bone hardens over the next several weeks. Once hardened and healed, the bone is then remodelled, reshaped and cleaned up over the course of the next year.
1️⃣Alignment of the broken bone fragments
It’s much easier for a bone to heal if the two bones are aligned with one another. Ensuring proper alignment of the bone fragments is very important.
Your focus for the coming weeks is to maintain proper alignment throughout the healing process. Follow your doctors’ instructions.
Stability and support at the fracture site through immobilisation
Understandably, one of the biggest challenges while recovering from a broken bone is remaining immobilised for an extended period.
But it’s also one of the most important things you can do to promote bone healing.
“Improperly immobilising a broken bone can absolutely slow bone healing. If your doctor’s orders were no weight lifting for two weeks, stay off the bone completely.
It will help promote the healing process and reduce painful swelling.
2️⃣ Healthy lifestyle choices that promote healing
Eating a healthy diet ensures your body has the nutrients, vitamins and minerals needed to support the biology of bone healing.
A healthy diet must be full of vegetables, fruits, lean protein, and water. Calcium, vitamin D and protein this will be important during the bone healing process,
So be sure you’re focusing on food sources rich in these nutrients, including dark, leafy greens, broccoli, fish, meat, yoghurt, nuts, and seeds.
However, older individuals, as well as those who have vitamin deficiencies, may benefit from taking a vitamin D with calcium supplement.
3️⃣ If you smoke, stop until you go through the healing process.
We know that smoking has a major impact on bone biology by negatively affecting the function of cells that create and lay new bone,
Smoking is always unhealthy, but, while nursing a broken bone, it becomes an added detriment to your health.
Conclusion on the healing time of a fractured forearm. In a few weeks your bones should consolidate well. After 2 to 6 months, you should be able to do everything like before.
Keep active during the healing process which also helps to promote bone healing.
I hope I have been able to answer your questions about forearm fractures.
I wish you a quick recovery
Any questions let’s meet in the comments sections.
Below are some of the resources used for this article.
📚References:
Bush LF, Love WH, Eiseman PC, Ferland JJ. Forearm fractures. Arch Surg. 1959 Dec;79:889-99. doi: 10.1001/archsurg.1959.04320120031004. PMID: 13806399.
Sheen JR, Mabrouk A, Garla VV. Fracture Healing Overview. [Updated 2023 Apr 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551678/
Srinivasan RC, Hutson RL, Richard MJ. Forearm Nonunion: Characterization and Management. J Hand Surg Am. 2020 Nov;45(11):1055-1064. doi: 10.1016/j.jhsa.2020.05.030. Epub 2020 Aug 13. PMID: 32800376.
Avenell A, Mak JCS, O’Connell DL. Vitamin D and vitamin D analogues for preventing fractures in post‐menopausal women and older men. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD000227. DOI: 10.1002/14651858.CD000227.pub4. Accessed 18 April 2024.
Xu W, Li D, Wang A, Gong M, Zheng S, Wang K, Wang L, Zhao D. [Effectiveness of open reduction and internal fixation for bipolar fracture-dislocation of forearm]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):149-153. Chinese. doi: 10.7507/1002-1892.202008004. PMID: 33624465; PMCID: PMC8171686.