ARM, BROKEN

A broken arm involves one or more of the three bones in your forearm and upper arm — the ulna, radius and humerus. One of the most common causes of a broken arm is falling onto an outstretched hand. If you think you or your child has broken an arm, seek prompt medical attention. It’s important to treat a fracture as soon as possible for proper healing.

Treatment depends on the site and severity of the injury. A simple break may be treated with a sling, ice and rest. However, the bone may require realignment (reduction) in the emergency room.

A more complicated break might require surgery to realign the broken bone and to implant wires, plates, nails or screws to maintain proper alignment during healing.

Common causes

  • Falls. Falling onto an outstretched hand or elbow is the most common cause of a broken arm.
  • Sports injuries. Direct blows and injuries on the field or court are a common cause of all types of arm fractures.
  • Significant trauma. Any of your arm bones can break during a car accident, bike accident or other direct trauma.
  • Child abuse. In children, a broken arm may be the result of child abuse.

Symptoms

An audible snap or cracking sound may be your first indication you’ve broken an arm. Signs and symptoms include:

  • Severe pain, which may increase with movement
  • Swelling
  • Bruising
  • Deformity, such as a bent arm or wrist
  • Inability to turn your arm from palm up to palm down or vice versa

When to see a doctor

If you have enough pain in your arm that you can’t use it normally, see a doctor right away. And do the same for your child. Delays in diagnosis and treatment of a broken arm, especially for children who heal faster than adults do, can lead to poor healing.

 

Types of Fractures

  • Open (compound) fracture. The broken bone pierces the skin, a serious condition that requires immediate, aggressive treatment to decrease the risk of infection.
  • Closed fracture. The skin remains unbroken.
  • Displaced fracture. The bone fragments on each side of the break aren’t aligned, which may require surgery to realign the bones.
  • Comminuted fracture. The bone is broken into pieces, which may require surgery for complete healing.
  • Greenstick fracture. The bone cracks but doesn’t break all the way through — like what happens when you try to break a green stick of wood. Most broken bones in children are greenstick fractures, because a child’s bones are softer and more flexible than are those of an adult.
  • Buckle (torus) fracture. One side of the bone is compressed, which causes the other side to bend (buckle). This type of fracture is also more common in children.

DIAGNOSIS

After discussing your symptoms and how you injured yourself and examining your arm, your doctor is likely to order X-rays to determine the extent of a fracture and injury to adjacent joints and pinpoint the location of the break. Occasionally, your doctor may also recommend another scan such as an MRI to obtain more-detailed images.

 

TREATMENT

Treatment of a broken arm will vary, depending on the type of break. The time needed for healing depends on a variety of factors, including severity of the injury; other conditions, such as diabetes; your age; nutrition; tobacco use and excessive use of alcohol.

Setting the bone

If you have a displaced fracture, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.

Immobilization

Restricting movement of a broken bone is critical to healing. To do this, you may need to wear a splint, sling, brace or cast. If your broken arm requires a cast, your doctor will likely wait until the swelling goes down, usually five to seven days after injury. In the meantime, you’ll likely wear a splint.

Your doctor may ask you to return for more X-rays during the healing process to make sure the bones haven’t shifted.

Medications

To reduce pain and inflammation, your doctor may recommend an over-the-counter pain reliever. If you’re experiencing severe pain, you may need to take a prescription medication that contains a narcotic for a few days.

Therapy

Rehabilitation begins soon after initial treatment. In most cases, it’s important, if possible, to begin some motion to minimize stiffness in your arm, hand and shoulder while you’re wearing your cast or sling. After your cast or sling is removed, your doctor may recommend additional rehabilitation exercises or physical therapy to restore muscle strength, joint motion and flexibility.

Surgery

Surgery is required to stabilize some fractures. If the fracture didn’t break the skin, your doctor may wait to do surgery until the swelling has gone down. Keeping your arm from moving and elevating it will decrease swelling.

Fixation devices — such as wires, plates, nails or screws — may be needed to maintain proper position of your bones during healing. Complications are rare, but can include infection and lack of bone healing.

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