Arm Fractures

Elbow fractures can involve any of the three bones that make up the joint (radius, ulna, and humerus). Radial neck fractures (the upper end of the radius) occur commonly in active adults after a fall on an outstretched arm. A tender spot develops on the outer side of the elbow and becomes painful when the arm is straightened. X-rays may just show a faint crack in less severe cases. Most people are treated with a sling. After 3 to 10 days, gentle stretching exercises are begun and are gradually increased, as tolerated by the person, to regain normal range of motion. Severe fractures may require cast or surgical treatment.

Colles' fractures (fractures of the radius at the wrist) occur commonly in older people, following a fall on an outstretched arm. People have pain, swelling, tenderness, and often the fracture causes the wrist to rest in an unnatural position. If the fracture is not badly displaced, a splint or cast is applied. Otherwise, reduction may be needed first. A cast may be worn for 3 to 6 weeks. Daily motion of the fingers, elbow (if free), and shoulder helps to avoid stiffness. Elevation of the hand is important to control swelling. Comfort, flexibility, and strength of the wrist continue to improve for 6 to 12 months after the fracture. These fractures require surgical treatment if the joint surface is out of place, especially in active adults who need to be able to fully use their wrist. An external fixator (a frame of rods clamped to stainless steel pins that pass through the skin into the bone) is often applied.