The forearm is made up of 2 bones, namely, the radius and ulna. The primary function of your forearm is rotation i.e., the ability to turn your palm up and down. The fracture of the forearm affects the ability to rotate your arm, as well as bend and straighten the wrist and elbow. In most of the cases, both bones are broken during a forearm fracture.
The forearm bones can break in several ways. The bones can crack slightly or can break into many pieces. Forearm fractures are generally due to automobile accidents; direct blow on the forearm or fall on an outstretched arm during sports, climbing stairs, etc.
The symptoms of a forearm fracture include intense pain in the arm, bruises and swelling. Your fractured forearm may appear bent and shorter compared to your other arm. You may experience numbness or weakness in the fingers and wrist. You may be unable to rotate your arm. In severe cases, a broken bone sticks out through the skin or the wound penetrates down to the broken bone.
A physical examination will be conducted, medical history recorded and x-rays ordered to evaluate the fracture.
Usually, people with forearm fractures are immediately rushed to the emergency room for treatment. Treatment of forearm fractures aims at putting back the broken bones into position and preventing them from moving out of place until they are completely healed.
In case only one bone is broken and is not out of place, Dr Bala might treat it with a cast or brace and provide a sling to keep your arm in position. Dr Bala will closely monitor the healing of the fracture with x-rays. If the fracture shifts in position, you may need to undergo surgery to fix the bones back together.
When both forearm bones are broken, surgery is usually required. During surgery (Open reduction and internal fixation), the cuts from the injury will be cleaned and the bone fragments are repositioned into their normal alignment. They are held together with screws and metal plates attached to the outer surface of the bone or on occasion a pin down the middle of the bone. Forearm fractures involving the lower 2/3rds are approached from the back of the forearm while those involving the upper 1/3 are approached from the front. Sometimes external pins and rods may be used to temporarily stabilize bones until the swelling resolves. This surgery can involve working very close to important blood vessels and nerves that supply your hand and Dr Bala uses special magnification loupes to visualize and protect these structures. The incision is sutured firmly and a sling is provided to facilitate healing. In the event you may have a tattoo on the forearm Dr Bala is well versed in suturing tattoos back accurately with absorbable sutures.
Following the surgery, a cast / splint may be required
Dr Bala also deals with poorly treated forearm fractures with malunion stiffness or infection to salvage upper limb function.