Forearm

Treatments

Nonsurgical Treatment

Treatments depend on multiple factors, such as the nature of the fracture, age and activity level of the patient, and the surgeon’s preferences.

If a broken bone is in a good position, a plaster cast might be applied until the bone heals. If the alignment of the bones is not good and likely to limit the future use of the arm, it will be necessary to correct the deformity. This realignment procedure is called a reduction. This can sometimes be done without an operation (closed reduction) and sometimes requires an operation (open reduction) (see below).

After the bone is properly aligned, a splint or cast may be fitted on your arm. A half cast or backslab is usually used for the first few days, to allow for normal swelling. A full cast is usually added a few days to a week or so later, after the swelling goes down.

The cast is changed again after two or three weeks as the swelling goes down and usually is replaced with a lightweight cast that can also be made waterproof.

Further X-rays are usually required at one and two weeks, particularly if the fracture required reduction or may be unstable.

In general, the cast is removed around six weeks after the injury. After removal, physiotherapy will help improve the motion and function of the injured wrist.

Surgical Treatment

Open reduction of the fracture may use a variety of implements for holding the bone in the correct position, including metal wires or a plate and screws. An external fixator (a device for which most of the hardware remains outside of the body), may be required in complex fractures with poor bone quality.

Recovery

Regardless of the treatment required, most fractures are likely to hurt moderately for a few days to a couple of weeks. Many patients find that using ice, elevating their arm in a sling, and simple, non-prescription medications such as paracetamol and ibuprofen are all that are needed.

Casts and splints must be kept dry. Covering your arm with a plastic bag while showering should help. If the cast does become wet, it will not dry very easily, using a hair dryer on the cool setting can help.

Surgical incisions must be kept clean and dry for five days or until the sutures/stitches are removed, whichever occurs later.

The cast will usually be removed following non-operative treatment at 5-6 weeks, but often earlier with internal fixation, as the plate and screws themselves are holding the bones in the correct position. This allows early range of movement exercises to reduce stiffness.

Most patients can start light activities, such as swimming or exercising the lower body in the gym, after the cast is taken off or after 4-6 weeks following surgery.

Most patients can resume more vigorous physical activities, such as skiing or football, between three and six months after the injury.

Almost all patients will have some stiffness in the wrist, which will generally lessen in the month or two after the cast is taken off or after surgery and will continue to improve for at least two years. Most patients return to their former activities, but some may have restrictions due to loss of range of movement.