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What is forearm fracture fixation?

Forearm fracture fixation is a term that refers to treating and healing a forearm fracture. A forearm fracture is a complete or partial break in one or both of the two bones in the forearm, a condition that occurs most commonly in children and the elderly. The best treatment for a forearm fracture depends on a number of factors including age, past and present health, the severity of the fracture and personal history with medications and other treatments. 

Diagnosis

A forearm fracture can cause significant pain and visible deformity. If you have been involved in a trauma and believe your forearm may be injured, it is important to seek medical attention immediately. To diagnose your injury, your doctor will ask you questions about past medical history and the recent trauma (if any), as well as perform a physical exam. One of the following tests will be done to determine the extent of the injury:

  • X-ray (radiograph)—This is the most common test performed to determine the extent of the injury. An X-ray beam is sent through the arm to create an image of the bone structure. This will show which bones have been broken or displaced in the trauma and if there are any pieces of bone that have come completely apart.
  • Pulse test—In some cases, the blood flow may be restricted by the breakage, causing the hand to lose circulation. The doctor will test the wrist to find the pulse and determine if blood is still flowing to this part of the body. 

Types of treatment

Nonsurgical treatment

In the majority of forearm fracture cases, surgery is required to ensure that both of the main bones (the radius and the ulna) return to normal function. However, most forearm fractures in children and adult forearm fractures involving only the ulna may be treated without surgery. These treatments include immobilizing the arm with a cast or splint. If necessary, the doctor will guide the bones to realignment prior to placing the forearm in a cast.

Surgery

The purpose of most forearm fracture surgery is to hold both bones in place so that they return to normal function. Without anatomic alignment of the radius and ulna, forearm rotation will be severely limited. Most forearm fractures are treated in one of the following ways:

  • Metal plate and screws—The most common surgical treatment uses metal plates and screws on both the ulna and radius to hold them in place as they heal. This helps to stabilize both bones so they can return to proper function. These plates and screws must be administered separately, usually requiring two incisions.
  • Metal rod—In rare cases, a metal rod is placed through the center of the bone. This rod must be designed specifically for the forearm, otherwise the rod could limit the rotational abilities of the bone. For this reason, this procedure is not performed as often. These rods frequently need to be removed. This is the most common type of forearm fracture fixation in children.
  • External fixation—When there is significant damage to the skin and tissue surrounding the bone, making more incisions may cause further damage. In this case, external pins are screwed in to the bone and connected with rods externally to repair the bone without damage.
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