When Your Child Has a Forearm Fracture
Your child has a forearm fracture. That means he or she has a crack or break in one or both of the forearm bones. The forearm is made up of 2 bones:
Radius. The bone on the thumb side of the forearm.
Ulna. The bone on the little-finger side of the forearm.
Your child may see an orthopedist for evaluation and treatment. An orthopedist is a doctor who diagnoses and treats bone and joint problems.
Types of forearm fractures
Types of fractures
Bones can break in many ways. Common types of fractures in children are:
Greenstick. The bone bends, but doesn’t break all the way through.
Nondisplaced. The bone breaks completely, but the ends remain lined up.
Displaced. The pieces of broken bone are not lined up.
Growth plate. A break near or through the growth plate, the soft part of a bone where the bone grows as the child grows. A growth plate injury can slow growth in that bone. Growth plate injuries may be difficult to treat.
Fractures can be open (the broken bone comes through the skin). These used to be called compound fractures. Fractures can also be closed (the broken bone does not come through the skin).
What causes forearm fractures?
Forearm fractures can happen when one or both of the forearm bones (the radius and ulna) are injured. Falling on an outstretched hand often leads to a forearm fracture. A direct hit to the forearm can also cause a fracture.
What are the symptoms of forearm fractures?
Skin bruising or color change
Extreme pain while putting weight or pressure on the forearm
Popping or snapping heard during the injury
Unable to move the arm normally
How are forearm fractures diagnosed?
You may have brought your child to the emergency room for the initial treatment of the forearm fracture. A treatment plan must now be made to make sure the forearm heals correctly. The healthcare provider will ask about your child’s health history and examine your child. An imaging test, such as an X-ray, will be done. Imaging tests show areas inside the body such as the bones. They give the healthcare provider more information about your child’s injury.
How are forearm fractures treated?
Your child’s treatment plan is determined by the type, location, and severity of the fracture. As instructed, your child should:
Ice the area 3 to 4 times a day for 15 to 20 minutes at a time. This can help relieve pain and swelling. To make a cold pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin. The cold pack can be put right on a cast or splint.
Wear a splint (device that keeps the forearm still so it can heal) as instructed while the swelling begins to go down.
Wear a cast for 3 to 6 weeks or more depending on the injury.
Elevate the arm to reduce swelling. Keep the forearm above heart level as often as possible.
Some fractures may require closed reduction (moving broken pieces of bone back into alignment). Closed reduction is done from outside of the body and requires no incisions. For fractures of the joint, of the growth plate, or severe fractures, surgery may be necessary. During surgery, fixation devices (pins, plates, or screws) may be put into broken bone to hold it in place while it heals. These devices may need to be taken out by the doctor 3 to 6 weeks or more after surgery.
Call the healthcare provider if your child has any of the following:
Fever (see “Fever and children” below)
Tingling, numbness, or pain around the cast or splint
Increasing swelling around the injured area
Fingers that change color or feel cold
Severe itching under a cast (mild itching is normal)
A cast or splint that feels too tight or too loose
Decreased ability to move fingers
Any drainage comes through or out of the end of the cast
A bad odor comes from underneath the cast
What are the long-term concerns?
Your child’s forearm may look different than it did before the fracture. It may look slightly crooked. This is normal. The bone is going through a process called remodeling. During remodeling, the repaired bone slowly reshapes itself. The forearm will usually straighten as the bone reshapes. This process often takes 1 to 2 years. There may also be a short-term (temporary) loss of motion. This is normal. Your child’s healthcare provider will give you more information.
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
April 27, 2018
Midshaft Forearm Fractures in Children. UpToDate.
Bass, Pat F. III, MD, MPH,Joseph, Thomas N., MD