Forearm fracture

Introduction

The bony structure of the forearm consists of two elongated bones – the ulna and the radius. When the palm is turned upwards, the radius is located at the thumb and the ulna at the little finger. A forearm fracture can occur proximally (near the elbow), medially (midway between the elbow and wrist) and distally (at the wrist).

The distal radius fracture, i.e. the fracture of the radius near the wrist, is the most common fracture in humans: About 25% of all bone fractures are caused by the so-called Colles fracture at the distal radius. Since there are more than 20 different muscles in the forearm, a fracture is often accompanied by a restriction of movement even after healing. In the case of forearm fractures, this can also be caused in particular by injury to one of the many nerves. Depending on the location, complications, healing time and primary treatment of the fracture vary.

Causes

Particularly frequent causes of forearm fractures are falls and injuries during sports and work. A complete fracture of the radius and ulna is a so-called “complete forearm shaft fracture”. Usually, however, only one of the two forearm bones is affected.

Typical of the distal forearm fracture according to Colles is the fall forward onto the outstretched hand. This is referred to as an extension fracture. This fracture is often regarded as relatively complicated because the bone structure in the wrist and at the transition between the radius, ulna and wrist bones is complicated.

A medial forearm fracture usually occurs after trauma, e.g. in a car accident or as a result of a sports accident. While the longitudinal load on the ulna and radius can be relatively high, a transverse load quickly leads to a fracture. However, falls – especially in old age – are also a common cause.

Patients usually fall to the side due to unsuitable footwear, “tripping hazards”, taking medication, or age-related frailty, and cushion the fall with an angled or outstretched arm. If the fracture takes place further proximal, i.e. near the elbow, it is called a proximal forearm fracture. This relatively rare fracture is also caused by trauma after traffic accidents or sports injuries. In these cases, the olecranon, the bony end piece of the ulna, can be detached. It corresponds to what is colloquially called the “elbow”.