Arm fracture

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 5, 2016
StartDiseasesArm fracture

An arm fracture is the medical term for the cracking or fracturing of one or more of the three major bones in the arm. Fractures in either the ulna, the radius, or the humerus bone can vary in severity: some fractures can be treated with regular icing and rest, while other more serious fractures need to be manually realigned by a medical professional or operated on in order to insert wires or screws to hold the broken bone in place. 

Contents

Definition & Facts

An arm fracture is one of the most common bone fractures, and usually makes up about half of all recorded fractures in adults. The fracture is usually caused by a fall or collision that impacts either the humerus, which is the bone that runs from the shoulder to the elbow, or the ulna and radius, which together make up the full forearm.

A normal closed fracture means that the fracture did not cause the skin to break, but an open or compound fracture means that the fracture caused a laceration in the skin. Fractures can be made more complex if they are accompanied by dislocations, which occur when a bone separates from a joint

Symptoms & Complaints

The symptoms of an arm fracture are usually fairly easy to recognize. When the injury is occurring, the first clue that a bone may be broken is an audible snap or crack that is heard at the point of contact. Further symptoms include severe pain or extreme pain that is exacerbated by movement, swelling, and bruising at the point of contact; a somewhat obvious deformity when compared to the other arm; and inability to move the arm in certain directions.

If the fracture is left untreated for several hours or days, the limb may also experience decreased sensation and numbness. Fractured bones will not heal properly if they are not treated in a timely manner, so it is important to see a medical professional if any of these symptoms are experienced after an accident. 

Causes

Nearly all arm fractures are caused by inadvertent falls or direct trauma. During many awkward falls, people will attempt to stabilize the falling body with the arms; this typically leads to the body's full weight being distributed to one hand, which can cause severe injury. The impact of the hand meeting the ground puts stress on the bones in the arm, which can cause fractures from the wrist up to the humerus depending on several factors including the height of the descent, the age and physical fitness of the person falling, and the angle of the arm at impact.

Direct trauma is the other major cause of arm fractures. It is usually sustained through the direct application of force to the arm -- this force can be the result of a car accident or other vehicular incident, physical abuse or contact with another person, or accidental impact from an object like a baseball bat or heavy ball. Trauma-induced bone breaks are easier to diagnose because the bone fracture typically occurs at the point of contact; fractures sustained from falls may be more difficult to locate because the bone breaks at a stress point, not necessarily the point of impact. 

Diagnosis & Tests

Doctors begin the diagnostic process by thoroughly questioning the patient on their medical history and the mechanics of their accident. The patient's account of the fall or trauma is the easiest way for the doctor to recognize the potential for a fractured or cracked bone. After the questioning period, the doctor will typically administer a physical examination to the impacted area, looking for signs of fractured bones such as deformity, bruising, swelling or sensitivity.

If the doctor suspects that a bone in the arm has been fractured, they will use X-ray technology to assess the affected area. X-rays allow the doctor to see an unimpeded view of the bone and discern if there is a noticeable disconnection in the picture. If the doctor believes that the fracture may be extremely small and therefore imperceptible on an X-ray, he or she may order an MRI or another imaging exam to check more thoroughly for a minute break. CT scans may also be used for further evaluation. 

Treatment & Therapy

The treatment of a fractured arm begins at home, before even going to the hospital. It is very important to stabilize the arm with a homemade sling made from a towel or a pillowcase and thoroughly ice the impacted area to decrease swelling and mitigate pain. Most fractured arms will have to be treated in the emergency room, but some minor fractures can be treated with outpatient procedures at a general practitioner's office.

For more serious fractures, including comminuted fractures and displaced fractures, the doctor may have to manually set the bone and utilize a cast or splint to immobilize the body part to encourage faster healing. As with any painful injury, the doctor often will recommend over-the-counter pain relievers or anti-inflammatory drugs to treat common symptoms.

Fractures that may require hospital admission include fractures that cause nerve damage, compound fractures at risk of infection, and fractures where the bone is broken in more than one place and cannot be set without surgery. The physical therapy and healing time for arm fractures varies with severity; some minor fractures may fully heal in a month, whereas some compound fractures require extensive rehabilitation exercises to improve muscle strength and joint flexibility

Prevention & Prophylaxis 

There is no easy way to prevent falls or accidents, but their effects can be diminished by wearing proper safety equipment during contact sports or properly utilizing safety measures such as automobile seat belts. Proper diet and exercise can also strengthen bones; high calcium intake helps protect bones and teeth from chipping or breaking under duress.

Weight-bearing physical activity helps strengthen bones and improves balance and posture. As people age, better balance and posture can help them avoid falls and therefore help avoid fractured bones.