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Treatment for Forearm Fractures in Children

Forearm fractures in children

TREATMENT

Treatment for forearm fractures depends on the type of fracture and the degree of displacement. Your doctor will use one of the following treatments, or a combination of both, to treat a forearm fracture.

Nonsurgical Treatment

Some stable fractures, such as buckle fractures, may simply need the support of a cast or splint while they heal.

For more severe fractures that have become angled, the doctor may be able to manipulate or gently push the bones into place without surgery. This procedure is called a closed reduction. Afterward, the arm is immobilized in a cast or splint while it heals.

 
Forearm cast
Casts support and protect broken bones while they heal.
Reproduced from Pring M, Chambers H: Pediatric forearm fractures. Orthopaedic Knowledge Online Journal 2007; 5(5). Accessed October 2014.

Surgical Treatment

In some cases, surgery is needed to align the pieces of bone and secure them in place. Your doctor may recommend surgery if:

  • The bone has broken through the skin—this type of injury (called an open fracture) is at risk for infection and requires specific treatment
  • The fracture is unstable—the ends of the broken bones will not stay lined up
  • Bone segments have been displaced
  • The bones cannot be aligned properly through manipulation alone
  • The bones have already begun to heal at an angle or in an improper position

During surgery, your doctor will open the skin and reposition the broken bone fragments (a procedure called an open reduction). Your doctor may use pins, metal implants, or a cast to hold the broken bones in place until they have healed.

 
Internal fixation of forearm fractures

In these x-rays, fractures in both the radius and the ulna have been repaired with plates and screws.

Reproduced from Pring M, Chambers H: Pediatric forearm fractures. Orthopaedic Knowledge Online Journal 2007; 5(5). Accessed October 2014.

Recovery

The length of time the cast is worn will vary depending on the severity of the fracture. A stable fracture, such as a buckle fracture, may require 3 to 4 weeks in a cast. A more serious injury, such as a Monteggia fracture, may need to be immobilized for 6 to 10 weeks.

When the cast is removed, the wrist and elbow joints may be stiff for 2 to 3 weeks. This stiffness will go away on its own, usually without the need for physical therapy.

For a short period of time, the forearm bones may be weaker due to immobilization in the cast. To allow the bones to safely regain their normal strength, the child should avoid playing on playground structures, such as monkey bars, for 3 to 4 weeks after the cast is removed.

If the fracture disrupts the growth plate at the end of the bone, it could affect the development of the bone. Your doctor may recommend follow-up visits for up to one year to ensure that growth is proceeding normally.

Statistical data in this article was reviewed by the AAOS Department of Research and Scientific Affairs.

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