Forearm Shaft Fractures: Understanding Radius and Ulna Injuries

What is a Forearm Shaft Fracture?

A forearm shaft fracture is a break in one or both bones that comprise the forearm, the radius, and the ulna. These fractures typically occur along the diaphysis or the long, middle portion of these bones. Forearm shaft fractures can result from direct trauma, such as a fall on an outstretched hand, a direct blow, or indirect trauma, like twisting injuries.

Types of Forearm Shaft Fractures

Three types of fractures can occur. Depending on the mechanism of injury, either one of the radius or ulna bones may be broken, or both bones may be broken.

The radius is in your forearm on the same side as your thumb. The ulna is in your forearm and is on the side of your pinkie finger. 

Radius Shaft Fractures:

  • Involve a break along the shaft (middle portion) of the radius bone.
  • It may occur alone or with other injuries.
  • It can be displaced (where bone ends are not aligned) or non-displaced.
  • Typically, it results from direct trauma or falls.

Ulna Shaft Fractures:

  • A fracture along the shaft of the ulna bone.
  • It is known as a “nightstick fracture” when caused by a direct blow, such as in self-defence.
  • It can be isolated or associated with radial head dislocations (Monteggia fracture).

Both-bone Forearm Fractures:

  • Involve fractures of both the radius and ulna shafts.
  • Usually, it results from significant trauma, like high-impact falls or motor vehicle accidents.
  • Often, surgical fixation is required due to the instability caused by the break in both bones.

Types of Pediatric Forearm Fractures:

Children’s bones are more flexible than adult bones, making them more likely to bend rather than break completely.

  • Greenstick Fractures:
    • Partial fractures, where one side of the bone bends and the other side breaks, are common in younger children due to their bones’ pliability.
  • Buckle (Torus) Fractures:
    • Compression fractures where the bone buckles under pressure but doesn’t completely break. These are stable fractures and often require minimal immobilisation.
  • Complete Fractures:
    • The bone is fully broken through, which may involve both the radius and ulna. These can be displaced or non-displaced.

All forearm shaft fractures require orthopaedic care. Access Ortho will offer urgent appointments if you are concerned you have a fracture or have a known fracture. Note that a fracture is the same as a break or crack; these are interchangeable words used when discussing bone injuries.

Forearm Fracture
Fracture of both the Ulna and Radius

Prevalence of Forearm Shaft Fractures

Forearm shaft fractures are relatively common, particularly among certain age groups and activities. Here’s an overview of their prevalence:

  • Children and Adolescents:
    • Forearm shaft fractures are the most common long bone fractures in children, often occurring during play or sports.
    • The peak incidence is between ages 10 to 14, with boys being more frequently affected than girls.
  • Adults:
    • These fractures are less common in adults but can occur due to high-energy trauma, for example car accidents or falls from a height.
    • Osteoporotic individuals, especially older women, are at higher risk for these fractures due to decreased bone density.
  • Sports and Occupational Hazards:
    • Athletes, particularly in contact sports or those involving falls (e.g., cycling, skiing), and workers in occupations with a high risk of falls or direct impact, have an increased prevalence of forearm shaft fractures.

Forearm shaft fractures are a significant concern in orthopaedic practice, particularly in paediatric and elderly populations. Access Ortho treats many patients with forearm shaft fractures. Seeking urgent orthopaedic care is essential for improving outcomes and minimising recovery time. Contact Access Ortho for an urgent appointment if you have concerns about a fracture or potential fracture. 

Symptoms and Causes

The symptoms, risk factors, and complications of forearm shaft fractures can vary depending on the patient’s age, the mechanism of the fall, and the type of fracture. 

Symptoms:

  • Pain: Significant pain at the site of the fracture, often worsening with movement.
  • Swelling: Swelling around the affected area, sometimes accompanied by bruising.
  • Deformity: Visible deformity or an abnormal shape of the forearm, especially in displaced fractures.
  • Tenderness: Localised tenderness at the fracture site.
  • Limited Mobility: Difficulty in moving the wrist, hand, or elbow.
  • Numbness: In some cases, nerve damage can cause numbness or tingling in the hand or fingers.

Common Causes of Forearm Shaft Fractures

  • Falls:
    • Falling on an outstretched hand (FOOSH injury) is a common cause, particularly in children and the elderly.
    • Slips and falls in everyday activities can result in these fractures, especially on hard surfaces.
  • Direct Trauma:
    • A direct blow to the forearm, such as in contact sports, physical altercations, or accidents, can lead to fractures.
    • Common in activities where the arm may be used defensively, such as in a “nightstick fracture.”
  • High-Energy Trauma:
    • Motor vehicle accidents, falls from significant heights, or industrial accidents often cause both-bone forearm fractures.
    • These injuries are typically more severe and may involve other associated injuries.

Risk Factors for Forearm Shaft Fractures

  • Age:
    • Children and adolescents have an increased risk due to active lifestyles and sports involvement.
    • Elderly individuals, particularly those with osteoporosis, are more prone due to reduced bone density.
  • Occupational Hazards:
    • Jobs that involve heavy manual labour, risk of falls, or exposure to direct trauma increase the likelihood of forearm fractures.
  • Sports Participation:
    • Athletes, especially those who play contact sports (e.g., football, rugby) or activities with a high risk of falls (e.g., cycling, skiing), are at a higher risk.
  • Bone Health:
    • Conditions like osteoporosis, osteopenia, or other bone disorders increase susceptibility to fractures.
  • Previous Fractures:
    • A history of previous fractures may indicate weaker bone structure, increasing the risk of future fractures.

Complications of Forearm Shaft Fractures

  • Malunion or Nonunion:
    • Improper healing can lead to malunion (healing in a misaligned position) or nonunion (failure to heal), which may require surgical correction.
  • Compartment Syndrome:
    • Swelling or bleeding within the muscle compartments of the forearm can lead to increased pressure, causing severe pain and potentially permanent damage if not treated promptly.
  • Nerve Damage:
    • Fractures can cause damage to surrounding nerves, causing numbness, tingling, or weakness.
  • Infection:
    • If surgery is required, there’s a risk of infection, particularly in open fractures where the bone pierces the skin.
  • Stiffness and Loss of Function:
    • Even after healing, some individuals may experience stiffness or a limited range of motion in the forearm, wrist, or hand, requiring physiotherapy for recovery.
  • Post-Traumatic Arthritis:
    • In some cases, especially with joint involvement or malunion, individuals may develop arthritis in the affected area over time

Access Ortho is staffed by orthopaedic specialists with expertise in managing forearm shaft fractures. Contact Access Ortho for an urgent appointment to ensure your injury is managed appropriately to minimise complications. 

Forearm Fracture
Arm injury

Diagnosis and Tests

How are Forearm Shaft Fractures Diagnosed?

The diagnosis of forearm shaft fractures typically involves a combination of physical examination and radiology.  Below is an overview of the process the medical team and Access Ortho may use to diagnose your injury:

Physical Examination:

  • Medical History:
    • The medical team will ask about the injury, including how it occurred, the level of pain, and any symptoms such as numbness or loss of movement.
    • The patient’s medical history, including previous fractures or bone-related conditions like osteoporosis, will also be reviewed.
  • Visual and Physical Assessment:
    • The forearm is inspected for visible signs of deformity, swelling, bruising, or open wounds.
    • The medical team will gently palpate (feel) the forearm to locate the exact site of pain and assess for tenderness.
    • Range of motion tests may be conducted to determine any limitations or pain during movement.
    • An assessment of nerve function may also be performed to check for any associated nerve injury, such as checking for sensation and motor function in the hand and fingers.

Tests Used to Confirm Forearm Shaft Fractures

The Access Ortho medical team may refer you for a radiology test to confirm if you have a fracture. There are radiology practices close to the Access Ortho clinics to ensure you can have x-rays rapidly and return to Access Ortho immediately for the results. Some other radiology tests may require an appointment that Access Ortho can help arrange. 

  • X-rays:
  • Primary Diagnostic Tool:
    • X-rays are the most common and effective imaging technique used to diagnose forearm shaft fractures.
    • They provide clear images of the bones, allowing the doctor to see the fracture’s location, type, and severity.
  • Views:
    • Multiple views (e.g., anterior-posterior and lateral) are taken to get a complete picture of the fracture and assess any displacement or angulation.
  • CT Scan (Computed Tomography):
  • Detailed Imaging:
    • A CT scan may be ordered if the X-ray is inconclusive or if a more detailed view of the fracture is needed, especially in complex or comminuted fractures (where the bone is shattered into several pieces).
    • It provides cross-sectional images that help evaluate the alignment of the bones and plan for surgical intervention if necessary.
  • Assessment of Joint Involvement:
    • CT scans are particularly useful in assessing any extension of the fracture into the joints or surrounding structures.
  • MRI (Magnetic Resonance Imaging):
  • Soft Tissue Evaluation:
    • Although less commonly used for diagnosing simple fractures, an MRI may be necessary if there is suspicion of associated soft tissue injuries, such as ligament or tendon damage, or if complications like compartment syndrome are concerns.
  • Occult Fractures:
    • MRI can also detect occult (hidden) fractures that are not visible on X-rays.
  • Bone Scans:
  • Fracture Healing Assessment:
    • In some cases, particularly if there’s a concern about delayed or nonunion (failure of the bone to heal), a bone scan may be used to assess the healing process.
  • Detecting Multiple Fractures:
    • Bone scans can also help detect other fractures that might not be immediately apparent, especially in cases of trauma involving multiple injuries.
  • Ultrasound:
  • Assessing Soft Tissue:
    • Ultrasound may be used in some cases to evaluate soft tissue injuries

Forearm shaft fractures are primarily diagnosed through physical examination and X-rays, with additional imaging tests like CT scans, MRIs, bone scans, or ultrasound used when more detailed information is needed to assess the fracture or associated injuries. Contact Access Ortho for a rapid appointment if you are concerned about an injury. 

Specific Considerations for Forearm Shaft Fractures

The following needs to be considered when treating a forearm fracture. 

Impact on Forearm Rotation:

  • Importance of Forearm Rotation:
    • The forearm’s ability to rotate (known as pronation and supination) is crucial for many daily activities, such as turning a doorknob, using tools, or lifting objects.
    • Forearm rotation involves the radius rotating around the ulna, and any disruption in this relationship due to a fracture can significantly impair function.
  • Impact of Fractures:
    • Alignment and Healing:
      • Proper alignment during healing is critical because even slight malalignment of the radius or ulna can severely restrict rotational movement.
      • Both bone fractures are particularly concerning, as they can lead to rotational deformity if not correctly realigned and stabilised.
    • Stiffness and Scar Tissue:
      • Immobilisation during healing can result in stiffness and the formation of scar tissue, which may further limit the range of motion.
      • In patients where the fracture involves the joints (e.g., distal radioulnar joint), there is a higher risk of long-term complications affecting rotation.
    • Post-Surgical Considerations:
      • Surgical fixation with plates, screws, or rods must be carefully planned to avoid restricting movement and to maintain the natural curvature and alignment of the bones for optimal rotation.

Pediatric Forearm Fractures:

  • Unique Characteristics in Children:
    • Bone Flexibility:
      • Children’s bones are more flexible than adult bones, making them more likely to bend rather than break completely. This results in unique fracture types like greenstick fractures, where the bone bends and cracks but does not break all the way through.
    • Growth Plates:
      • Pediatric forearm fractures often involve the growth plates (epiphyseal plates), which are the areas of developing tissue at the ends of long bones. Injury to these plates can affect bone growth, leading to potential deformities or length discrepancies.
    • Healing Capacity:
      • Children have a remarkable ability to heal, with fractures often mending more quickly and efficiently than in adults. However, proper alignment is crucial to ensure the bone heals correctly and does not impact future growth or function.

Management and Treatment

Treatment for forearm shaft fractures depends on the type, location, and severity of the fracture. The patient’s age and overall health also has an impact. There are two primary approaches: non-surgical management and surgical interventions.

Non-Surgical Management:

  • Immobilisation:
  • Casting or Splinting:
    • The primary treatment for non-displaced or minimally displaced fractures is immobilisation with a cast or splint.
    • The cast typically extends from the elbow to the wrist, keeping the forearm stable and allowing the bones to heal in the correct position.
    • In children, where the bones are more pliable and heal rapidly, casting is often sufficient, even for some displaced fractures, due to the bones’ ability to remodel as they grow.
  • Reduction:
  • Closed Reduction:
    • For displaced fractures, a procedure called closed reduction may be performed. This involves manually realigning the bones without making an incision.
    • After realignment, the forearm is immobilised in a cast or splint to maintain the correct position during healing.
    • This is often done under sedation or anaesthesia to minimise pain and ensure proper alignment.
  • Monitoring:
  • Regular Follow-Up:
    • X-rays are taken periodically to monitor the healing process and ensure the bones remain properly aligned.
    • Follow-up appointments are crucial to detect any complications early on, such as malunion (improper healing) or nonunion (failure to heal).
  • Physiotherapy:
  • Rehabilitation:
    • Once the cast or splint is removed, physiotherapy may be encouraged to improve strength and range of motion in the forearm, wrist, and hand.
    • Exercises focus on reducing stiffness, improving muscle function, and gradually returning to normal activities.

Surgical Interventions:

  • Indications for Surgery:
  • Surgery is typically recommended for:
    • Displaced fractures that cannot be properly aligned with closed reduction.
    • Both-bone forearm fractures, as these are often unstable and require surgical stabilisation.
    • Open fractures, increase the risk of infection and may complicate healing.
    • Fractures that have failed to heal with non-surgical methods (nonunion) or have healed improperly (malunion).
    • Fractures involving the joints or those associated with nerve or vascular injuries.
  • Surgical Techniques:
  • Open Reduction and Internal Fixation (ORIF):
    • The most common surgical procedure for forearm shaft fractures is ORIF, where the bones are surgically exposed, realigned, and stabilised with internal hardware such as plates, screws, or rods.
    • Plates and Screws:
      • Metal plates are fixed with screws to the bone to hold the fractured ends together in the correct position.
      • This method provides strong, stable fixation, allowing for early movement and rehabilitation.
    • Intramedullary Rods (Nails):
      • A rod may be inserted into the marrow canal of the bone (intramedullary nail) to stabilise the fracture from within.
      • This technique is less invasive and often used for certain types of fractures, especially in the radius or ulna.
  • External Fixation:
    • In cases of severe trauma, open fractures, or significant soft tissue damage, an external fixator may be used. This involves placing pins or screws into the bone above and below the fracture site, these are connected to an external frame outside the body.
    • External fixation stabilises the fracture while allowing access to the wound for cleaning and monitoring.
    • This method is often temporary until the patient is stable enough for ORIF or until the soft tissues heal.
  • Post-Surgical Care:
  • Rehabilitation:
    • After surgery, physiotherapy is essential to restore function and strength, focusing on range-of-motion exercises and gradual strengthening.
    • The timing and intensity of rehabilitation depend on the type of surgery and the patient’s overall condition.
  • Monitoring for Complications:
    • Regular follow-up visits are important to monitor healing, check the position of the hardware, and ensure there are no complications such as infection, hardware failure, or delayed union.
  • Removal of Hardware:
    • In some cases, especially in children or if the hardware causes discomfort, it may be removed after the bone has fully healed.

The orthopaedic team at Access Ortho will determine the best treatment plan for your injury. If reduction under anaesthetic or surgery is required, Access Ortho will assist in finding a surgeon to do this in an appropriate time frame. Contact Access Ortho for a rapid appointment. Note that if you have an open fracture (bone through the skin or open wound over the fracture) or significant deformity, you are best to go straight to your nearest emergency department.

Forearm Fracture
Cast for forearm shaft fracture

Prevention

The following strategies can be taken to minimise the risk of forearm shaft fractures:

  • Preventing Falls:
  • Home Safety: To decrease the risk of falls, ensure living areas are free of hazards like loose rugs, clutter, and poor lighting, especially for the elderly.
  • Proper Footwear: Wear shoes with good grip and support to prevent slips, particularly on wet or uneven surfaces.
  • Protective Gear:
  • Sports Equipment: To minimise injury risk, wear wrist guards, elbow pads, and other protective gear when playing sports like skateboarding, cycling, or rollerblading.
  • Occupational Safety: Workers in high-risk jobs should wear protective equipment, such as arm guards and gloves, to prevent trauma.
  • Bone Health:
  • Calcium and Vitamin D: To strengthen bones, ensure your vitamin D and  calcium intake is sufficient. Supplements may be necessary, particularly for those at risk of osteoporosis.
  • Regular Exercise: Engage in weight-bearing exercises like walking, jogging, or resistance training to strengthen bones and improve balance, reducing fracture risk.
  • Osteoporosis Management:
  • Bone Density Testing: Regular screening for osteoporosis, especially in postmenopausal women and older adults, to detect and treat bone weakening early.
  • Medications: Use prescribed medications to manage osteoporosis and reduce the likelihood of fractures.
  • Safe Physical Activities:
  • Supervision for Children: Ensure children are supervised during play, particularly in activities with a high risk of falls, such as climbing or cycling.
  • Proper Training: Learn and practice safe techniques in sports and physical activities to avoid improper falls or impacts that could lead to fractures.
  • Ergonomic Practices:
  • Workplace Ergonomics: Implement ergonomic practices in the workplace to reduce the risk of accidents that could lead to forearm injuries, especially in manual labour jobs.

Reducing the risk of forearm shaft fractures involves a combination of fall prevention, protective gear usage, maintaining strong bones through diet and exercise, managing osteoporosis, engaging in safe physical activities, and practising good ergonomics. These strategies are particularly important for children, athletes, older adults, and individuals in high-risk occupations.

Outlook / Prognosis

What to Expect with a Forearm Shaft Fracture

  • Initial Symptoms and Diagnosis:
  • Pain and Swelling: Expect significant pain, swelling, and possible bruising immediately after the injury. There may also be visible deformity if the fracture is displaced.
  • Immobility: You may find it difficult or impossible to move your wrist, hand, or elbow.
  • Medical Attention: An accurate diagnosis requires a visit to a medical practitioner. This may be the emergency department, Access Ortho Fracture clinic, or another medical practitioner.
  • Treatment:
  • Non-Surgical Management: Treatment may involve immobilisation with a cast or splint if the fracture is non-displaced or minimally displaced. If the bones need to be realigned, a closed reduction might be performed.
  • Surgical Intervention: For more severe fractures, especially displaced, open, or both-bone fractures, surgery (e.g., ORIF) will likely be required to realign and stabilise the bones.
  • Pain Management: Pain relief is typically managed with medications, including over-the-counter painkillers or prescribed analgesics.
  • Post-Treatment Care:
  • Immobilisation: The forearm will be immobilised to allow the bones to heal. This will be for a number of weeks in a cast or splint. 
  • Follow-Up Visits: Regular follow-ups with X-rays are necessary to check the healing process and ensure proper alignment.
  • Rehabilitation:
  • Physiotherapy: After the immobilisation period, physiotherapy may be required to restore strength, flexibility, and range of motion in the forearm, wrist, and hand.
  • Gradual Return to Activities: You will need to gradually resume normal activities, starting with light tasks and progressively moving to more strenuous activities as the bone heals.

Recovery Time for Forearm Shaft Fractures

  • Children:
    • Healing Time: Children typically heal faster than adults, with most forearm shaft fractures healing within 6 to 8 weeks.
    • Rehabilitation: Although they may require a shorter period of rehabilitation, follow-up is crucial to monitor bone growth and ensure no long-term complications.
  • Adults:
    • Healing Time: In adults, the healing time for forearm shaft fractures is generally longer, ranging from 8 to 12 weeks.
    • Surgical Recovery: If surgery is required, the initial healing of the bones may take around 6 to 8 weeks, but full recovery, including rehabilitation, can take 3 to 6 months or more.
    • Return to Activities: Light activities might be resumed after a few weeks, but a full return to heavy lifting or high-impact activities may take several months.
  • Factors Affecting Recovery:
    • Severity of the Fracture: More complex fractures, such as those involving both bones or requiring surgery, will have longer recovery times.
    • Age and Health: Older adults, especially those with osteoporosis, may experience delayed healing. Overall health, including nutritional status and the presence of chronic conditions, can also impact recovery.
    • Compliance with Rehabilitation: Adhering to physiotherapy and rehabilitation exercises is crucial for regaining full function and reducing the risk of complications.

Recovery from a forearm shaft fracture varies between patients. The above is a guide only, and you must take advice from your treating doctor. Access Ortho will advise patients regarding their treatment plan and provide orthopaedic specialist follow-up care to minimise complications and recovery time. 

When to Seek Medical Attention

It’s essential to seek medical attention rapidly if you suspect a forearm shaft fracture to ensure proper diagnosis and treatment. Here are key signs and situations that indicate the need for immediate care:

  • Severe Pain and Swelling:
    • Persistent Pain: If you experience intense pain that does not subside with rest, ice, or over-the-counter pain relief, it could indicate a fracture or a complication that needs urgent attention.
    • Rapid Swelling: Swelling that develops quickly, particularly if associated with bruising or deformity, is a strong indicator of a fracture.
  • Visible Deformity:
    • Unnatural Alignment: If your forearm looks crooked or there is a noticeable bend or twist in the bone, this suggests a displaced fracture that requires immediate medical intervention.
    • Bone Protrusion: In cases where the bone breaks through the skin (an open fracture), immediate emergency care is required to prevent infection and other complications.

IF YOU HAVE SIGNIFICANT DEFORMITY OR BONE PROTRUSION, YOU NEED TO ATTEND YOUR NEAREST EMERGENCY DEPARTMENT

  • Inability to Move the Arm, Wrist, or Fingers:
    • Loss of Function: If you are unable to move your forearm, wrist, or fingers, or if movement causes severe pain, this could indicate a serious fracture or associated nerve damage that requires urgent care.
  • Numbness or Tingling:
    • Nerve Involvement: Numbness, tingling, or a “pins and needles” sensation in your hand or fingers may indicate nerve damage caused by the fracture. This is a medical emergency, as prolonged nerve compression can lead to permanent damage.
  • Cold or Pale Skin:
    • Circulation Problems: If the skin on your hand or fingers becomes cold, pale, or bluish, it may indicate a lack of blood flow, which can be caused by a fracture affecting blood vessels. This requires immediate medical evaluation to restore circulation.
  • Open Wound or Severe Bleeding:
    • Open Fracture: If there is an open wound at the site of the injury, especially if the bone is visible, you should seek emergency care to prevent infection and properly manage the wound and fracture.
    • Uncontrolled Bleeding: Significant bleeding that cannot be controlled with pressure needs urgent attention.

IF YOU HAVE AN OPEN WOUND OR SEVERE BLEEDING, YOU NEED TO ATTEND YOUR NEAREST EMERGENCY DEPARTMENT

  • Signs of Shock:
    • Symptoms of Shock: Look for signs such as dizziness, weakness, rapid heartbeat, shallow breathing, or confusion, which can occur with severe fractures or trauma and require immediate emergency care.
  • Compartment Syndrome Symptoms:
    • Severe Pain and Swelling: If the pain and swelling continue to worsen even with immobilisation and elevation, it may indicate compartment syndrome, a serious condition where increased pressure in the muscle compartment can cut off blood supply, leading to tissue damage.
    • Tense and Hard Muscles: If the muscles in your forearm feel unusually tense or hard to the touch, this is a critical sign of compartment syndrome, and immediate medical intervention is necessary.

IF YOU HAVE CONCERNS THAT YOU ARE DEVELOPING COMPARTMENT SYNDROME, SEEK CARE IMMEDIATELY FROM YOUR NEAREST EMERGENCY DEPARTMENT

 Early medical intervention is crucial to ensure proper treatment and optimal recovery. Access Ortho provides rapid orthopaedic care for fractures. 

Understanding Fracture Clinics

Role of Fracture Clinics in Forearm Shaft Fracture Management

Fracture clinics, such as Access Ortho, play a crucial role in managing forearm shaft fractures, providing specialised care throughout the recovery process. Here’s an overview of their role:

 Initial Assessment and Diagnosis:

  • Comprehensive Evaluation:
    • Fracture clinics provide detailed assessments following the initial injury, often including physical examinations and referral for diagnostic imaging (X-rays, CT scans) to confirm the fracture and evaluate its severity.
  • Treatment Planning:
    • Based on the assessment, the clinic develops an appropriate treatment plan, which may include non-surgical management or referral for surgical intervention if necessary. Access Ortho are specialists in orthopaedic care and offer expertise in fractures. 

Treatment Implementation:

  • Casting and Immobilisation:
    • For non-surgical cases, fracture clinics manage the application and adjustment of casts or splints to immobilise the fracture and ensure proper healing. Access Ortho offers a range of casts to suit your fracture. 
  • Surgical Coordination:
    • If surgery is required, fracture clinics coordinate with orthopaedic surgeons to schedule and plan surgical procedures, including open reduction and internal fixation (ORIF) or other surgical interventions.

Monitoring and Follow-Up:

  • Regular Check-Ups:
    • Access Ortho provides follow-up appointments with orthopaedic surgeons to monitor healing progress, assess alignment, and make any necessary adjustments to casts or splints. Some fracture clinics do not offer this. 
  • Imaging:
    • Follow-up X-rays or other imaging studies are often performed to track the healing process and detect any complications such as malunion or nonunion.

Rehabilitation and Physiotherapy:

  • Rehabilitation Services:
    • Access Ortho coordinates access to physiotherapy and rehabilitation services if required to help restore strength and movement after the fracture has healed.
  • Guidance on Exercises:
    • Patients receive guidance on appropriate exercises and activities to aid in recovery and prevent stiffness or loss of function.

Complication Management:

  • Identification and Treatment:
    • Expert Orthopaedic care is required to identify and manage complications such as compartment syndrome, nerve damage, or infection that may arise during the healing process. Access Ortho is staffed with specialist orthopaedic surgeons, ensuring you receive a high level of orthopaedic care. 
  • Referral and Coordination:
    • Access Ortho, fracture clinic, will coordinate with other specialists and ensure appropriate referrals for further evaluation and treatment in cases requiring specialised care, such as complex fractures or complications.

Patient Education:

  • Information and Advice:
    • Fracture clinics should provide education on managing the injury, including how to care for the cast or splint, signs of complications, and when to seek additional medical attention. As Access Ortho is staffed by orthopaedic surgeons, you will receive specialist care for your injury. 
  • Guidance on Activity:
    • Patients receive advice on gradually resuming normal activities and the importance of adherence to rehabilitation protocols to ensure optimal recovery.

Fracture clinics play a vital role in managing forearm shaft fractures. It is important to ensure that the clinic you attend, along with initial assessment and treatment, offers care for you through recovery and rehabilitation. Access Ortho, fracture clinic, offers specialised services, including casting, surgical coordination, follow-up monitoring, complication management and patient education, to ensure effective and complete recovery. Contact Access Ortho for a rapid appointment for acute injuries. 

Frequently Asked Questions About Forearm Shaft Fractures

What is the difference Between Radius and Ulna Fractures?
  • Radius Fracture:
    • Location: The radius is the bone on the thumb side of the forearm.
    • Common Fractures: These include distal radius fractures (e.g., Colles’ fracture), often resulting from falls onto an outstretched hand.
    • Impact: Affects wrist movement and can influence hand function.
  • Ulna Fracture:
    • Location: The ulna is the bone on the pinky side of the forearm.
    • Common Fractures: These include fractures of the ulna shaft or the olecranon (elbow end of the ulna).
    • Impact: Affects elbow movement and stability, influencing the ability to rotate the forearm.

Can You Move Your Arm with a Forearm Shaft Fracture?

With a forearm shaft fracture, you may experience significant pain and restricted movement. Simple, stable fractures may allow some movement, but more severe or displaced fractures typically result in minimal or no movement due to pain.

How Long Does It Take for a Forearm Shaft Fracture to Heal?
  • Children: Typically heal in 6 to 8 weeks due to their faster bone regeneration.
  • Adults: Generally take 8 to 12 weeks. Full recovery, including rehabilitation, can extend to 3 to 6 months, depending on fracture complexity and individual healing.
Will I Need Surgery for My Forearm Shaft Fracture?

Surgery may be necessary for:

  • Displaced fractures that cannot be realigned with casting.
  • Both-bone fractures or complex fractures.
  • Open fractures with exposed bone.
  • Nonunion or malunion cases where the bone does not heal properly.

Non-surgical management, such as casting and immobilisation, may be suitable for stable, non-displaced fractures.

What Activities Should I Avoid During Recovery from a Forearm Shaft Fracture?

Your medical team will provide advice on what to avoid during recovery from a forearm shaft fracture. In general, you should avoid:

  • Avoid Heavy Lifting: Do not lift heavy items or perform strenuous activities that stress the forearm.
  • Avoid High-Impact Sports: Refrain from participating in contact sports that pose a risk of re-injury.
  • Avoid Aggressive Movements: Avoid twisting or turning motions that could disrupt the healing process.

How Does a Forearm Shaft Fracture Affect Daily Activities?

A forearm shaft fracture can affect the following:

  • Hand Function: Difficulty with gripping and fine motor tasks. This is typically due to the cast required to immobilise the fracture and after the cast is removed due to muscle weakness and joint stiffness. 
  • Wrist and Elbow Movement: Restriction in movement impacts activities like typing, cooking, or driving due to the cast required to immobilise the fracture.
  • Self-Care: Challenges with personal grooming and daily chores due to limited use of the affected arm.

Are Forearm Shaft Fractures Common in Children?

Yes, forearm shaft fractures are quite common in children, especially those aged 5 to 14. These often result from falls during play or sports activities. Children’s bones heal faster and typically respond well to non-surgical treatments.

What’s the Best Way to Sleep with a Forearm Shaft Fracture?

It can be challenging to find a comfortable position if you have a cast on to manage a forearm fracture. Consider the following: 

  • Elevation: Sleep with the forearm elevated on a pillow to reduce swelling.
  • Support: Use pillows to support the arm and keep it comfortable, avoiding pressure on the fracture site.
  • Avoid Pressure: Ensure the cast or splint is not compressed or disturbed.
Can I Drive with a Forearm Shaft Fracture?

Driving with a forearm fracture is not advised. You should discuss this with your medical team during your recovery. You should not drive a car until you can ensure you can control the vehicle safely and comfortably. In addition to the risks of being unable to control the vehicle, if you have an injury, your insurance may not cover you in case of an accident. 

What Exercises Can Help Rehabilitate a Forearm Shaft Fracture?

After your cast is removed, you may experience some stiffness in the surrounding joints and muscle weakness. The following may assist with improving arm and hand function. It is important to always follow the advice of your treating medical team. 

  • Range of Motion Exercises:
    • Wrist Flexion/Extension: Gently move the wrist up and down within a pain-free range.
    • Elbow Bending/Stretching: Perform gentle elbow bends and stretches.
  • Strengthening Exercises:
    • Grip Strengthening: Use a soft exercise ball or putty to improve grip strength.
    • Forearm Curls: With light weights or resistance bands, perform forearm curls to build strength.
  • Coordination and Functional Exercises:
    • Finger Tapping: Bring each finger to the thumb to improve fine motor skills.
    • Writing Practice: Practice writing or other hand movements to regain dexterity.

Note: Always consult with a physiotherapist or medical provider before starting exercises to ensure they are suitable for your specific condition and stage of recovery