Pediatric Orthopedic Surgeons treating a Radius Ulna Fractures


The radius and ulna are the two bones that make up your forearm. The majority of forearm fractures in children involve both broken bones. 

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Radius Ulna Fractures

The radius and ulna are the two bones that make up your forearm. The majority of children with forearm fractures involve both broken bones. These breaks occur most often in the center of the forearm, at the upper (proximal) end closest to the elbow, or at the furthest (distal) end closest to the wrist. The  radius and ulna are the subject of this article’s discussion.

What is a Broken Forearm?

One or both of the bones that link the elbow and wrist may break in a fractured forearm. The forearm consists of two bones: The ulna bone is on the pinky finger side of the forearm, whereas the radius bone is on the thumb side. One of the most frequently fractured bones in kids is forearm fractures. Children frequently break their arms when playing and falling. Forearm fractures can happen in the center of the bone or close to the wrist or elbow joints. The radius and ulna bones will often shatter together in most accidents. The severity of the fracture, the suggested course of treatment, and the length of your child’s recovery will all depend on how the forearm fractures.

Radius Ulna Fractures Symptoms

Symptoms of a broken arm may include:

  1. Acute, immediate agony
  2. Swelling and sensitivity
  3. Forearm, hand, or elbow numbness
  4. Forearm, elbow, or wrist deformity
  5. Having trouble rotating or twisting the forearm

Different Types of Forearm Fractures

Forearm fractures can be unilateral (just affecting the radius or ulna) or multiple (affecting both bones). These are referred to as Galeazzi or Monteggia fractures when both bones are broken at separate levels and there is damage to the joint at the wrist or elbow.

Galeazzi fracture

There is a problem with both forearm bones. In the majority of instances, the wrist joint sees an ulna dislocation and a shattered radius.

Monteggia fracture

This injury needs rapid medical attention since it affects both forearm bones. Typically, the wrist’s radius is dislocated and the ulna has broken.

Both Bones and Forearm Fracture

A patient in their adult years who sustains a fracture to both bones usually needs surgery. Without surgery, the forearm is frequently unstable, making it impossible to cast this kind of fracture. Nonsurgical therapy options are available for younger children, but surgery is normally needed for teens. Placing a metal plate and screws on the radius and ulna bones is the most typical treatment for both forearm bone fractures.

How is a Forearm Fracture Treated?

The manner of treatment for a forearm fracture is determined by the patient’s age, the kind of fracture, and how severe the fracture is. One fundamental principle governs the treatment of shattered bones: the fragmented bones must become repositioned and restrained from shifting as they recover. Proper stabilization of the radius and ulna are important because they support each other. Future issues with wrist and elbow mobility may occur from incorrect bone alignment throughout the healing process. Surgery is usually necessary for adult forearm fractures in order to align the bones and stabilize them for proper healing.

Immediate Treatment

Depending on how far out of position the fragments are, the doctor may attempt to temporarily realign the bones while you are still in the emergency department. The precise word for this procedure, in which the doctor arranges the components, is reduction. This is not a surgical procedure. Medication will help you manage your pain. After that, your doctor will put a splint (similar to a cast) on your forearm and give you a sling to hold your arm in place. A splint, as opposed to a complete cast, may get adjusted for tightness or looseness and for swelling to take place without risk.

Controlling a shattered bone’s mobility is crucial. Moving a broken bone may result in further injury to the bone, surrounding blood vessels, surrounding nerves, and other tissues. Your child will also receive pain medicine and an ice pack as additional rapid therapy to aid with swelling reduction.

Nonsurgical Treatment for Radius Ulna Fractures

Doctors can treat a fractured bone with only a cast or brace if there is just one broken bone and it is not misaligned. Your doctor will regularly order X-rays at the clinic and closely examine the healing of the fracture. You could need surgery to put the bones back together if the fracture moves.

Surgical Treatment for Radius Ulna Fractures

Surgery is often necessary when both forearm bones are broken, or if an open fracture has occurred where the bones have pierced the skin. Open fractures typically require prompt surgery due to the increased risk of infection. In the emergency room, patients frequently get intravenous (IV) antibiotics as well as a tetanus injection. The cuts from the injury will be meticulously cleaned out during surgery. Usually, the shattered bones are mended during the same procedure. Multiple procedures can be necessary to thoroughly clean the affected soft tissues in cases with severe open wounds. If the skin around the fracture is intact, your doctor may recommend waiting until the swelling subsides before having surgery. Keeping the arm still above heart level for several days reduces swelling. It also gives the overly stretched skin a chance to recover.

With Plates and Screws, Perform an Internal Reduction

Forearm fractures most frequently require this kind of surgical treatment. The doctor initially realigns (reduces) the broken pieces of bone during this treatment. A combination of metal plates affixed to the outside of the bones and specialized screws hold the bones together.

Internal rod fixation and open reduction

In this treatment, a specifically crafted metal rod is inserted by the surgeon through the marrow space in the middle of the bone.

External fixation

Using plates and screws and making wide incisions may worsen the skin’s damage if the muscles, bone, and skin are already badly compromised. This might cause an infection. You could receive treatment with an external fixator in this situation. The procedure involves inserting metal pins into the bone above and below the fracture location. A bar outside the skin holds the pins and screws. In order to allow the bones to mend, this device acts as a stabilizing frame.

Complications from Radius Ulna Fractures Surgery

Any operation, whether it is to treat a forearm fracture or anything else has the danger of infection. Nerve and blood vessel damage in the area of the forearm is a small possibility.  Synostosis, a bridge of bone that forms when the two forearm bones heal together, is another uncommon consequence. This may limit the bones’ ability to rotate and prohibit some mobility. Surgery does not ensure that the fracture will heal and parents should understand that further surgery may occur if the fracture does not heal.

The screws, plates, and rods used to repair the fracture may move or shatter — causing a fracture to tear apart. There are several causes for this, including the patient disobeys instructions.  Some illnesses, such as diabetes, impede the healing process. Healing is also slowed down by smoking and other tobacco use. Healing is frequently slower if the fracture involved an incision on the skin. Additionally, infections might hinder or delay the healing process.

Depending on the severity and location of the fracture, the elbow or wrist may become stiff. The whole rotation of your palm upward and downward can not function proberly.  Plates placed over the bone can cause discomfort, especially if placed at the end of the ulna just below the skin. Symptomatic plates may get taken off later when the fracture has healed. Loss of reduction is the most typical side effect of non-operative therapy. This indicates that the bone ends closest to the location of the fracture drift apart. Surgery could be necessary if parents persist with non-operative treatment and healing does not occur.

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