Most people know right away if they broke their arm due to a snap or loud cracking sound, extreme pain at the site of the injury, pain increased by any movement, and / or loss of normal use of the arm. Arms often break due to a fall on an outstretched arm or major accident such as a car crash. Common fracture points include the wrist, radius (forearm), elbow, and humerous.

Trying to break a fall by putting your hand out in front of you seems almost instinctive, but the force of the fall could travel up your lower forearm bones and dislocate your elbow. It also could break the smaller bone (radius) in the forearm. The breaks can occur at the wrist (Colles fracture), or near the elbow at the radial “head.” Children are more likely to break the bones in their lower arm, which are called the radius and ulna. A direct blow to the elbow or fall on a bent elbow can cause it to break. About one in every 20 fractures involves the upper arm bone which is called the humerus.

If you have any of these signs or symptoms after a fall, see your doctor:

• Pain or swelling at the site of the injury (outside of the elbow, wrist, etc)
• Pain increased by any movement of the injured area
• Loss of normal use of the arm.
• Difficulty in bending or straightening the elbow accompanied by pain
• Inability or difficulty in turning the forearm (palm up to palm down or vice versa)
• Numbness in one or more fingers.

First Aid

Because breaks often occur as a result of an accident first aid is usually required.

1. Make sure the injured person is out of the way of further harm.
2. Check to see if they are breathing normally.
3. Check their pulse.
4. Call 911 if their breathing and/or pulse are irregular, if there is serious bleeding, or if there is reason to suspect multiple broken bones or other injuries.
5. Elevate the injured arm above the person’s heart. This slows bleeding and reduces swelling.
6. If the bone is sticking out from the skin do not try to push it back in. Instead, cover it with a clean, dry cloth or bandage.
7. Do not use the broken arm. Moving the arm could cause further injury. To immobilize a broken arm:
   • Make a temporary splint. Find something long and stiff to attach to the site of the injury. Wood or rolled up magazines or newspapers attached to the arm with cloth, belts or tape can be used to immobilize the joint. Make sure both ends of the splint extend far above and below the injury. Tie the splint tight enough to hold it in place, but not so tight as to reduce blood flow.
   • Make a sling. Place the injured arm across the chest with the hand resting near the shoulder. Use a loop of cloth supported from the neck and around the arm to stabilize the injury and support the splint.

Take the injured person to a doctor immediately

November 2001, AAOS

Repairing a Broken Arm

The Doctor’s Visit

Tell the doctor exactly what happened. He or she will physically examine the broken arm and check for other injuries, such as nerve damage. The doctor may want to see if the patient can flex and extend the wrist and fingers. Sometimes the doctor may use X-rays or other diagnostic imaging tools to see the bones of both the injured and uninjured arms.

What to Expect

The doctor may need to move pieces of bone back into their correct positions (a process called reduction). Depending upon the severity of injury, the patient may or may not need anesthesia. Those with more serious fractures may require surgery.

Once the broken bone is back in place the arm is immobilized by placing it in a cast or splint. You will be advised how long to wear the cast or splint, and given a follow-up appointment to check on the bone healing and cast removal.

Fracture Types and Treatments

Radial head fractures are classified according to the degree of displacement (movement from the normal position).

Type I fractures are generally small, like cracks, and the bone pieces remain fitted together.

• The fracture may not be visible on initial X-rays, but can usually be seen if the X-ray is taken three weeks after the injury.
• Nonsurgical treatment involves using a splint or sling for a few days, followed by early motion.
• If too much motion is attempted too quickly, the bones may shift and become displaced.

Type II fractures are slightly displaced and involve a larger piece of bone.

• If displacement is minimal, splinting for one to two weeks, followed by range of motion exercises, is usually successful.
• Small fragments may be surgically removed.
• If the fragment is large and can be fitted back to the bone, the orthopaedic surgeon will first attempt to fix it with pins or screws. If this is not possible, however, the surgeon will remove the broken pieces or the radial head.
• The surgeon will also correct any other soft-tissue injury, such as a torn ligament.

Type III fractures have more than three broken pieces of bone, which cannot be fitted back together for healing.

• Usually, there is also significant damage to the joint and ligaments.
• Surgery is always required to remove the broken bits of bone and repair the soft-tissue damage.
• Early movement is necessary to avoid stiffness.

Regardless of the type of fracture or the treatment used, physical therapy will be needed before resuming full activities.

Cast Care

It’s important that you take good care of your cast during your recovery period. Information regarding the care of your cast can be found here.

Recovering from a Broken Arm

Rehabilitation

It may take from several weeks to several months for the broken arm to heal completely. Rehabilitation involves gradually increasing activities to restore muscle strength, joint motion and flexibility. The patient’s cooperation is essential to the rehabilitation process by completing range of motion, strengthening and other exercises prescribed by the doctor. Rehabilitation lasts until tissues perform their functions normally. After rehabilitation, the doctor may want to see the arm again to make sure healing is complete.

Cast Care

It’s important that you take good care of your cast during your recovery period.