Forearm Fracture - Medical Malpractice Lawyer
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Fracture of the Forearm Overview
A fractured forearm is a fracture of at least one of two bones of the distal forearm. In the case of adults, it usually involves a fracture of both bones, named the radius and ulna. Fractures of the forearm can involve the wrist, the midshaft of the bones and the part of the bones near the elbow. The bone of the forearm that attaches to the thumb of the hand is the radius. The bone of the hand that is connected to the little finger part of the hand is the ulna. Both bones are responsible for the rotation of the forearm. Rotation of the forearm is called pronation (with the palm down) and supination (with the palm up).
The forearm can break if a person falls on the outstretched hand. A motor vehicle accident or pedestrian accident can cause a forearm fracture as can a bat or other object to the side of the forearm. Sometimes bony fragments can stick out of the skin in what’s called an open fracture. These are at high risk for infection.
The symptoms of a fractured forearm usually come on immediately after the injury. There is usually an obvious deformity adding to the pain. The forearm is often bent and foreshortened. Other symptoms include being unable to rotate the arm, swelling of the forearm, bruising and numbness or weakness of the distal fingers and wrist.
When injured, the doctor will determine the mechanism of injury and evaluate the fracture. He will look for open skin indicative of a possible open fracture. The pulses will be evaluated to make sure there isn’t a disruption of the vasculature. Movement is evaluated in the forearm and the rest of the arm. The forearm is evaluated for sensation as well. Plain film x-rays will usually show the fracture, especially done when two separate pieces of film are taken.
In treating the bones, the two broken fragments of each bone must be placed and connected with one another. This is usually done in the emergency room shortly after the injury occurs. When the two bones are in the act of coming together, this is called a reduction. It can be done in the operating room but it is usually done in the ER by an ER doctor. X-rays are done to confirm that the bony fragments are properly aligned. When reduction has taken place, a cast is applied and is kept on the forearm for approximately six weeks. The forearm is held in a specific position such that it appears the hand is holding a glass comfortably in front of the body. Pain medication is given to be used as needed.
If both bones are broken or if there is an open fracture, surgery is necessary. If there is a lot of swelling, then ice is used to shrink the swelling until surgery can be done under better circumstances. The broken bones are set with pins, screws and plates and are kept in the body indefinitely. This procedure is called an open reduction with internal fixation. Usually an orthopedic surgeon is responsible for doing this type of procedure.
An open reduction can be done using intramedullary rods. The rods keep the bones in proper alignment while an attached plate and screws are attached to the other bony segment. This makes for a strong connection and an accurate alignment of the pieces of bone.
External fixation uses screws attached on the outside of the forearm. It is done as a temporary measure whenever the patient is multiply injured and too sick to have surgery right away.
Complications of a forearm fracture include tearing of tissue like nerves and blood vessels, infection from an open fracture, and excessive bleeding or swelling. Even when surgery is done well, there can be complications. These include surgical infection, damage to vessels and nerves, nonunion and a condition known as synostosis, in which there is a bridge of bone between the radius and the ulna.
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