Broken Arm Overview
A broken arm involves one or more of the three bones in your arm the ulna, radius and humerus. One of the most common causes of a broken arm is falling onto an outstretched hand. If you think you or your child has broken an arm, seek prompt medical attention. It’s important to treat a fracture as soon as possible for proper healing.
Treatment depends on the site and severity of the injury. A simple break may be treated with a sling, ice and rest. However, the bone may require realignment (reduction) in the emergency room.
A more complicated break might require surgery to realign the broken bone and to implant wires, plates, nails or screws to maintain proper alignment during healing.
Broken Arm Causes
Almost all injuries to the arm that result in a broken bone are caused in two ways: falls and direct trauma.
- The typical fall that produces a fracture occurs when a person falls on an outstretched hand. The location of the fracture can be from the wrist up to the shoulder depending on the direction of the fall, the age of the person, and other factors that modify the stresses applied to the bone.
- Direct trauma can be from a direct blow from an object such as a bat, the trauma during a car accident, or any accident that causes the direct application of force to a part of the arm.
Broken Arm Symptoms
An audible snap or cracking sound may be your first indication you’ve broken an arm. Signs and symptoms include:
- Severe pain, which may increase with movement
- Deformity, such as a bent arm or wrist
- Inability to turn your arm from palm up to palm down or vice versa
Broken Arm Diagnosis
The initial evaluation by any physician, in the office or in the emergency department, begins with a thorough history and physical exam. By finding out the details of the accident, the doctor is able to determine what damage was done based on the mechanism of the trauma.
After taking a history, the physician will do a complete physical exam with special focus on the painful areas. The doctor is looking for signs of a fracture (such as swelling or deformity) and checking for possible nerve or blood vessel damage.
X-rays are typically the test used to assess for broken bones. At least two views of the arm are taken. Initially, most broken bones will have an apparent fracture or other abnormality on the X-ray. Some fractures are not always visible on the first set of X-rays. In those instances, a CT scan or MRI may be performed immediately for further evaluation, or follow-up X-rays may be obtained at a later date.
How a broken arm or wrist is treated
A broken arm or wrist is usually treated in a hospital accident and emergency department. The treatment differs depending on the severity of the injury.
First, a doctor will give you or your child painkillers and then fix a splint to the arm to secure it in position and prevent further damage.
An X-ray will be taken of the arm to see what kind of fracture it is. Even hairline fractures should show faintly on X-ray.
A simple fracture where the bone remains aligned can be treated by applying a plaster cast. This holds the broken ends together so they can heal. You will be provided with painkillers to take home and information on how to look after your cast. An appointment will be made to attend a fracture clinic so specialist orthopaedic doctors can take over the care of your fracture.
With more severe arm or wrist fractures, the bones can become misaligned (displaced). If the bone is not realigned (reduced), the bones will not heal well. Doctors can use a technique called ‘closed reduction’ to pull the bones back into position.
Local or regional anesthetic will be used to numb the arm (this is rarely used in children), or you will be put to sleep using a general anaesthetic. If doctors are happy with the bones’ new position, you may be treated with a plaster cast and regular follow-up appointments and X-rays.
Certain fractures are best treated with surgery to realign and fix the broken bones. This includes displaced fractures, fractures involving a joint, and open fractures. Surgeons can fix bones with wires, plates, screws or rods. This is called open reduction and internal fixation (ORIF). Any metalwork is usually not removed unless it becomes a problem.
In rare cases an external frame is used to hold the broken bones, known as an external fixator.
After most surgery, a plaster cast is applied to protect the repair. A sling may also be provided for comfort. If you have surgery, you will usually be able to go home within a day or two.