Fractures can happen anywhere along the forearm, and can include one or both bones (the radius or the ulna). These fractures are treated with a cast, which may a long arm cast (“above the elbow”), or a short arm cast (“below the elbow”). Some fractures may need to be manipulated to correct alignment, and others can be simply treated with a cast.
What to Expect . . .
The cast
- You will need to return for repeat x-rays in the first 1-2 weeks to be sure that the fracture is healing in the correct alignment inside the cast.
- Because swelling goes down during the first 2 weeks, the cast often needs to be changed during this visit.
- The cast will be short arm cast if the fracture is closer to the wrist, but will need to be a long arm cast if it is in the middle of the forearm or closer to the elbow.
- Most forearm fractures are treated with a cast for 6 weeks.
- You still need to be careful! If you take a fall with the cast on, the fracture can move.
After the cast
- It is normal for the arm to feel funny or even hurt a little after the cast is removed. Your arm has to get used to being an arm again!
- There is a risk of re-fracture of about 1-5%. This means that as many as 1/20 kids can break their arm again. I recommend 2 weeks of limited activities and no sports to decrease this risk.
- Most kids do not need physical therapy and their range of motion will recover on its own over several weeks.
- Try the “push-up” test at home and make sure you are comfortable doing this before returning to sports.
Fracture remodeling
Sometimes, you may notice a bump where the fracture was, or difference between the two arms. Because kids are growing, the bones can reshape, or remodel themselves over time to appear more smooth and symmetric.
Surgery
Some fractures cannot be held in good alignment in the cast, and can be treated with surgery. Common techniques include pinning, flexible nails, or plates and screws.
