II. Definition

  1. Mid-shaft Fracture of the radius and/or ulna

III. Signs

  1. Usually shortened and displaced

IV. Complications

  1. High rate of non-union in adults
  2. Risk of unstable Fractures even when initially non-displaced and despite external immobilization
  3. Radial Head Dislocation in proximal ulnar Fracture (Monteggia Fracture)

V. Imaging

  1. Xray should show entire Forearm including wrist and elbow

VI. Indications: Referral

  1. Orthopedic referral is indicated in most cases

VII. Management: Adults

  1. Displaced Forearm Fractures
    1. May attempt closed reduction
    2. Open reduction and Internal Fixation (ORIF)
      1. Usually indicated
      2. Length of immobilization is shorter
  2. Non-displaced Forearm Fractures
    1. Long Arm Cast with elbow at 90 degrees for 8-12 weeks

VIII. Management: Children

  1. Surgical intervention rarely needed
  2. Reduction Technique
    1. Light Anesthesia
    2. Angulated Fractures
      1. Traction and Counter traction
      2. Greenstick Fractures
        1. Often require breakage of opposite cortex
        2. Prevents re-angulation in cast
    3. Displaced Fractures
      1. Traction and Counter traction
      2. Slight bayonet apposition is acceptable
      3. Alignment must be satisfactory
  3. Immobilization in Long Arm Cast for 7-8 weeks
    1. Elbow flexed to 90
    2. Mold Forearm to avoid interosseus encroachment

IX. Management: Follow-up

  1. Examine at weekly intervals for 3 weeks
  2. Inspect for re-angulation
    1. Angulation under 2 weeks
      1. Correct angulation manually
    2. Angulation over 2 weeks
      1. Angulation may be permanent

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Ontology: Fracture of forearm (C1305215)

Concepts Injury or Poisoning (T037)
ICD10 S52 , S52.9
SnomedCT 208292008, 213497006, 65966004
English Fract of forearm, unspecif, Fracture of forearm, part unspecified, Fracture of forearm, unspecified, [X]Fract of forearm, unspecif, [X]Fracture of forearm, unspecified, Unspecified fracture of forearm, forearm fractures of, Fracture;forearm, forearm fractures, forearm fracture, fracture of forearm, fracture forearm, [X]Fracture of forearm, unspecified (disorder), Fracture of forearm (diagnosis), fracture upper limb forearm, Forearm fracture, Fracture of forearm, Fracture of forearm (disorder), Fracture of forearm, NOS, Forearm Fracture, fractured forearm
Italian Frattura dell'avambraccio
Japanese 前腕骨折, ゼンワンコッセツ
German Fraktur des Unterarmes, Teil nicht naeher bezeichnet, Fraktur des Unterarmes, Fraktur des Unterarms
Czech Zlomenina předloktí
Korean 아래팔의 골절, 상세불명의 아래팔 부분의 골절
Hungarian Alkartörés
Spanish fractura del antebrazo, fractura del antebrazo (trastorno), [X]fractura del antebrazo, no especificada, [X]fractura del antebrazo, no especificada (trastorno), fractura de antebrazo (trastorno), fractura de antebrazo, Fractura de antebrazo
Dutch Fractuur van onderarm, deel niet gespecificeerd, onderarmbreuk, Fractuur van elleboog en onderarm
Portuguese Fractura do antebraço
French Fracture de l'avant bras