Displaced Fracture of the Radius and Ulna

 

Radius and Ulna Fractures

 Fractures of the shaft of the radius and ulna are referred to as "both bones forearm fractures" in Orthpaedics or BBFAF for short. These injuries are usually due to a direct blow to the side of the forearm.  The more common in children than adults, especially during contact sports.  In children under10 years of age, the primary treatment is closed reduction (setting the bone without making an incision) and casting.  Children between 10 and 15 are in a grey zone but I generally accept much less deformity in adolescents than children under 10.  The reason is that smaller children have a huge potential to reodel fracture deformity while adolescents and adults have limited ability to remodel and this potential decreases as you approach skeletal maturity.   

 

        

 

Examples of High Energy Forearm Fractures

 

 Forearm fractures in adults are almost always treated with surgical repair. Non-operative management leads to poor outcomes with loss or rotation of the wrist and diminished grip strength in the involved hand. Alignment and length of both bones is critical for wrist function as the radius rotates around the ulna. If left untreated, displacement or shortening of the radius results in marked limitation of rotation of the wrist.  Treatment involves realigning the bones and securing them with a plate and screws. Surgical repair takes approximately 45 minutes and can be performed as an outpatient. After surgery, patients wear a split (soft cast) for about 2 weeks and then begin a fairly aggressive protocol with physical therapy to regain range of motion in the forearm. Recovery is generally fairly quick and most patients regain full function within 8-12 weeks after surgery.

 

     

 

"Both bones" forearm fractures after repair

 

For patients undergoing surgery, I recommend considering a cast cover to protect the cast from getting wet while bathing. Cast covers are pre-formed bags shaped like an arm or leg with a plastic diaphram at the top.  They are available from a number of vendors online and help keep the cast from getting moisture while allowing you to enjoy your shower.  I generally keep the cast on for about 3 weeks before changing it, so if you are supposed to be in a cast for 6 weeks, I will generally change the cast after the first 3 weeks.  For children, make sure they don't put things "in" the cast. I have recovered all manner of objects from inside children's casts from pocket change to earrings to keys to small lizards. 

 

 

   

 

 

http://castcoversnow.com/

 

http://www.nextag.com/waterproof-cast-covers/search-html

 

http://www.brokenbeauties.com/fashion-new/castcovers-arm.php

 

If you're having surgery or already had surgery on your arm, I suggest you go over the post op instructions for forearm/wrist fractures.  This page will cover a lot of the questions you may have from how to take care of your cast to what problems are normal/ common and which ones you need to be conerned about.  I have included the link below

 

Post op Instructions Forearm/ Wrist surgery