The forearm is the section between the wrist and elbow that is subject to injury. Two bones make up the forearm: the radius and ulna. Forearm fractures account for over thirty per cent of fractures in children. Trauma resulting from an injury due to a fall or motor vehicle accident can damage the forearm. In addition, a sudden fall or direct blow to the forearm can result in a fracture. The fracturing of the forearm causes pain and numbness in the arm a tingling sensation in the arm is due to nerve damage.
A detailed physical exam of the hand entails checking for a deformity around the wrist, forearm and elbow. In addition, signs of tenderness, swelling and an inability to rotate the arm signal a forearm fracture. By looking at the arm in further detail, we ensure the hand's circulation and nerves are unaffected.
Forearm fractures can occur in several areas of the arm, including the wrist, the middle of the forearm and near the elbow. When the forearm is fractured, the broken pieces of bone need to be reduced into the correct position and fixated in order to mobilise the arm without displacing the fracture. In some cases, surgery may be required, in which case, an open reduction and internal fixation procedure are most likely to be recommended. In this case, the bones are severely displaced, so I may push the bones back using surgical instruments. Plates and screws are most commonly used, and in children, I mostly use titanium elastic nails if required. Open reduction is a procedure that rearranges the bones using pins and screws. Finally, a cast is used to hold the bones in place. Once the cast has been removed, the elbow will remain stiff for at least three weeks; this is to be expected. Typically, stiffness at the elbow will dissipate, especially after physical therapy.
A broken forearm can be extremely painful. The pain is immediate, and the break can cause a deformity in that part of the bone. The forearm will also appear more bent and much shorter than normal.
It is important to take prescription medication, preferably one containing an analgesic, for several days. Non-steroidal anti-inflammatories are effective in treating pain but are only followed for a few days because their use may slow down the healing of the bones.
Johannesburg Surgical Hospital, 219 Beyers Naude Drive,
Northcliff
Randburg
2195
