What are the other Names for this Condition? (Also known as/Synonyms)

• Broken Forearm in Children

What is Forearm Fracture in Children? (Definition/Background Information)

• The forearm (between the wrist and elbow) consists of two bones - radius and ulna; the radius is the larger of the two bones
• Forearm Fractures in Children are breaks or cracks that may occur near the lower part of the forearm near the wrist (distal region), the center of the forearm, or at the upper part of the forearm near the elbow (proximal region)
• A high percentage of children who sustain Forearm Fractures, do so in the radius, near the wrist or at the bone shaft, which is considered the middle of forearm (between wrist and elbow). However, both the radius and ulna may be injured

There are several different types of Forearm Fractures in Children, some of which are categorized based on the injury impact force. The fracture types include:

• Open fracture: In this type of fracture, the bone breaks and pierces the skin, requiring immediate medical treatment
• Closed fracture: In this type, the bones do not pierce the skin. However, injury to the soft tissues under the skin, may occur
• Displaced fracture: In this type of fracture, the bone may fragment around the point of breakage and get misaligned; hence, surgery is usually required
• Comminuted fracture: In a comminuted fracture, the bone is broken into three or more pieces. It is considered one of the most unstable type of fracture
• Greenstick fracture: A greenstick fracture means that the bone is cracked, but not broken all the way through
• Buckle (or torus) fracture: A buckle fracture, also known as a torus fracture, occurs when one side of the bone is compressed or buckled, without fracturing the other side
• Metaphyseal fracture: With this type, the fracture injury is confined to the upper/lower part of the shaft, but does not affect the growth plate
• Galeazzi fracture: A fracture that extends through an area of the bone, causing the bone to bend on the other side
• Monteggia fracture: A fracture type that affects both sides of the forearm. This is a severe injury and requires immediate medical treatment
• Growth plate fracture (physeal): This type of fracture occurs around the growth plate

Who gets Forearm Fracture in Children? (Age and Sex Distribution)

Forearm Fractures in Children are non-specific fractures, and as such, may occur in children of any race, ethnic group, and gender.

What are the Risk Factors for Forearm Fracture in Children? (Predisposing Factors)

Common risk factors associated with Forearm Fractures in Children include:

• Participation in high-risk contact sports, such as football
• Falls, accidents

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Forearm Fracture in Children? (Etiology)

Some of the causes of a Forearm Fracture in Children include:

• Direct trauma to the arm/forearm due to an automobile accident
• Taking part in any rough or high-impact sport
• Falling from a significant height; especially landing on one’s arm

What are the Signs and Symptoms of Forearm Fracture in Children?

Forearm Fractures in Children, may be very painful making it difficult to move the arm or elbow. The signs and symptoms include:

• Severe pain at the site, where the injury occurred.
• Signs of bruising, swelling of the forearm
• Stiffness or inability to move the arm, wrist, or elbow
• Tenderness to touch
• In some rare cases, the pieces of bone may protrude through the skin

How is Forearm Fracture in Children Diagnosed?

Diagnostic methods that a physician may use to help diagnose Forearm Fractures in Children include:

• Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, within the forearm. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray: X-rays are the most common method in evaluating a fracture, if the bone has been displaced. This diagnostic test helps provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Forearm Fracture in Children?

Complications associated with Forearm Fractures in Children:

• Malunion: A serious complication that might occur, if the bone in the forearm heals in an improper position
• Nonunion: Another serious complication is, if the bone in the forearm does not heal adequately, shifts to an improper position, receives an inefficient supply of blood flow, or becomes infected
• Damage to the nerves or blood vessels of the forearm
• Abnormal pressure build-up within the muscles of the arm/elbow that reduces blood flow, preventing oxygen and nourishment from reaching the nerve and muscle cells (termed as compartment syndrome)
• The immobilization required to heal Forearm Fractures may occasionally result in painful shoulder inflammation, stiffness, and reduced range of motion (frozen shoulder)
• Osteoporosis: A disease that causes bones to weaken and become more brittle
• Infection of the bone (osteomyelitis)

How is Forearm Fracture in Children Treated?

The goals of treating Forearm Fractures are to realign the bone, encourage rapid recovery, and help the individual to resume regular/daily activities, as early as possible.

Nonsurgical treatment methods include:

• Oral medications, such as ibuprofen, can help decrease pain
• Complete immobilization of the forearm with a splint or cast, may be required to restrict movement
• Applying ice to the forearm can help reduce pain and swelling
• Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the forearm muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality

Surgical treatment methods include:

• Closed reduction: Closed reduction is a surgical method that involves realigning the bone back to its original position, without making an incision at the fracture site. This procedure is usually performed under a local anesthesia
• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

How can Forearm Fracture in Children be Prevented?

To prevent a Forearm Fracture, children should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must also be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or a Forearm Fracture include:

• Individuals, who participate in any high-risk sports, should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size) may help prevent accidents
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Forearm Fracture

What is the Prognosis of Forearm Fracture in Children? (Outcomes/Resolutions)

• The majority of Forearm Fractures in Children heal without any serious complications
• Individual may return to sports or normal daily activities, when advised by their physician
• When properly treated and rehabilitated, a high percentage of children regain their full strength and range of motion in the injured forearm

Additional and Relevant Useful Information for Forearm Fracture in Children:

Forearm Fractures in Children are common injuries that account for roughly, half of all fractures in children.