There two long bones in the forearm. They are ulna and radian. Radius is the longer among the two arm bones and is on the thumb side and ulna is the shorter and is on the pinky side of the forearm. Fractures occurring on the forearm bones can be classified into three categories. The first category consists of the fractures occurring at the farthest (distal) end of the forearm bones. The second category consists of the fractures occurring at the middle area of the forearm bones. The last category consists of the fractures occurring at the top (proximal) end of the forearm bones. Children’s bone fractures have an additional category known as growth plate fractures. Growth plates are areas near the ends of the children’s forearm bones. Growth plates are made of cartilages.
Forty to fifty percent of childhood bone fractures are forearm fractures. Children’s bone fractures heal more quickly than of grown up’s. So if a bone fracture is suspected among children immediate medical attention is necessary. Children are very playful and are often engaged in activities like jumping, skipping, running etc. Falling on an outstretched arm can cause the breakage of one or both the bones of the forearm.
Torus fracture: This is a stable fracture in which the top most layer on one side of the bone is compressed causing the other side of the bone to bend away from the growth plate. In this fracture the broken pieces of the bone are not displaced.
Metaphysical fracture: The lower or upper portions of the shafts of the bones are fractured in this case and the growth plates remain unaffected.
Greenstick fracture: In this type the fracture extends over the entire circumference of the bone and causes it to bend.
Galeazzi fracture: In this type both the bones of the forearm are broken. Ulna is dislocated in the wrist and the radius is displaced.
Monteggia fracture: In this type of fracture the radial head is dislocated and the ulna is fractured. This is a serious case of forearm injury and requires immediate medical attention.
Growth plate fracture: These are fractures occurring across the growth plate and they usually affect the growth plate in the radius.
Severe pain and numbness are the common symptoms of forearm fractures. Swelling, numbness, deformity to the hand and inability to move, turn or rotate the arm are the common symptoms. Physical examinations will be enough to reveal a fractured forearm. But diagnostic examinations using X-ray will be done to understand the exact locations and extent of the fracture.
Mild fracture like buckle fracture can be cured by the support of a splint or cast. For angled fractures your doctor may try to push the bones back to the normal position and provide support by plastering or casting. Immobilization using a cast for 3 to 4 weeks will be enough for small fractures like buckle fracture and this period may extent to 8 to 10 weeks for cases like monteggia fracture.
Surgical intervention will be necessary in the cases were the bones have started to heal in an unnatural position, where the bones cannot be properly aligned by manual methods, where broken bone is projection out, where bone segments have been displaced etc.
When cast is removed after the necessary period for healing the joints may be stiff which can be overcome by proper physiotherapy. When the cast is removed the bones may be week. So children have to be more careful for 3 to 4 weeks in their activities and try to avoid possible re fracturing. As there can be problems with growth plate after the completion of the surgical procedure the doctor may require the patient to visit him regularly for a few years for his observation and continued medical intervention, if necessary.
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