Broken arm

A broken arm happens when one or more of the three arm bones break. The arm bones include the ulna, radius and humerus. A break also is called a fracture.

Falling onto an outstretched hand is one of the most common causes of a broken arm. If you think you or your child may have a broken arm, seek medical care right away. It's important to treat a fracture as soon as possible for proper healing.

Treatment depends on the location and severity of the break. For a simple fracture, a healthcare professional may recommend a sling, ice and rest to allow healing. In many people, especially children, broken arms heal well in a cast. But sometimes the bone may need to be realigned in the emergency room. Realigning the bone is called a reduction.

For a more serious fracture, surgery may be needed to realign the bone. The bone may be secured with wires, plates, screws or nails to keep it stable while it heals.

Sometimes it's easy to tell that an arm is broken, such as when it looks crooked. Other times, it can be harder to tell. Common symptoms include:

• Intense pain that worsens with movement.
• Swelling around the injured area.
• Bruising.
• Difficulty bending the elbow.
• Difficulty raising the arm.
• Difficulty rotating the forearm, making it hard to turn the palm up or down.
• Visible change in the arm, such as a bent or twisted arm or wrist.

When to see a doctor

If your arm hurts so much that you can't use it as you typically do, see a healthcare professional right away. Get emergency medical care right away if you notice any numbness, weakness or changes in skin color of your hand. Seek emergency medical care if there is bleeding or a break in the skin. The same goes for your child. Getting prompt medical care is important, especially for children. Children heal faster than adults. Waiting to get treatment can lead to poor healing.

Common causes of a broken arm include:

• Falls. Falling onto an outstretched hand or elbow is the most common cause of a broken arm.
• Sports injuries. A direct hit or impact while playing sports can cause various types of arm fractures.
• Serious accidents. Car crashes, bike accidents and other major impacts can break any of the arm bones.
• Child abuse. Sometimes, a broken arm in children may be a sign of child abuse.

Some medical conditions and activities increase the risk of a broken arm.

Sports and physical activities

Playing sports with physical contact or a high risk of falling increases the chance of breaking an arm. Examples include football, soccer, gymnastics, skiing and skateboarding.

Weak bones

Conditions that weaken bones, such as osteoporosis and bone tumors, increase your risk of a broken arm. A break caused by an underlying condition is called a pathological fracture.

With early treatment, most broken arms heal well. But complications can happen, including:

• Uneven bone growth. In children, a fracture near a growth plate can affect bone development, leading to uneven growth. Growth plates are found at the end of a long bone where growth occurs.
• Osteoarthritis. If a fracture extends into a joint, it can increase the risk of arthritis in that joint later in life.
• Stiffness. When a fracture in the upper arm bone requires a splint, sling, brace or cast, it may lead to stiffness and limited movement in the wrist, elbow or shoulder.
• Bone infection. If a broken bone pierces the skin, bacteria can enter and cause an infection. Immediate medical care is needed to prevent serious complications.
• Nerve or blood vessel injury. A severe fracture of the humerus can have sharp, jagged edges. The broken bone may damage nearby nerves and blood vessels. If you have numbness or swelling in your injured arm, seek emergency care right away.
• Compartment syndrome. Swelling in the injured arm can cut off blood supply, leading to pain, burning, tingling and numbness. Typically this happens within 24 to 48 hours after the injury. Casts that are too tight or that become too tight due to swelling can cause compartment syndrome. Compartment syndrome is a medical emergency that requires surgery.

While accidents can't always be prevented, these steps may help protect your bones:

• Eat for strong bones. Include calcium-rich foods, such as milk, yogurt and cheese, along with vitamin D. Vitamin D helps your body absorb calcium. Good sources of vitamin D include fatty fish, such as salmon, and fortified foods, such as milk and orange juice. And sunlight helps your body produce vitamin D.
• Stay active. Weight-bearing exercises and activities that improve balance and posture can strengthen bones and reduce the risk of fractures. The more active and fit you are as you age, the less likely you are to fall and break a bone.
• Prevent falls. Wear supportive shoes and remove tripping hazards from your home, such as loose rugs. Keep your home well lit and install grab bars or handrails where needed, such as in bathrooms and stairways.
• Use protective gear. Wear wrist guards and other safety equipment during high-risk activities, such as inline skating, snowboarding, rugby and football.
• Don't smoke. Smoking weakens bones, increasing the risk of fractures. And smoking slows the healing process if a break occurs.

A healthcare professional examines your arm for tenderness, swelling, unusual positioning and open wounds. You're asked about your symptoms and how the injury happened. To confirm the break and assess the severity, it is typical to have an X-ray. Sometimes, a CT scan, an MRI or another imaging study may be used for more-detailed images.

Treatment for a broken arm depends on the type of fracture. Healing time varies based on factors such as the severity of the break, age, overall health and nutrition. Smoking and alcohol use may slow healing.

Types of fracture include:

• Open fracture, also called a compound fracture. The broken bone pierces the skin, creating a serious risk of infection. Immediate medical treatment is needed to lessen the risk of infection.
• Closed fracture. The bone is broken, but the skin remains intact.
• Displaced fracture. The bone fragments aren't aligned. Surgery may be needed to realign and stabilize the fragments.
• Comminuted fracture. The bone is broken into multiple pieces, often requiring surgery.
• Greenstick fracture. The bone cracks but doesn't break all the way, similar to bending a green twig. This type is common in children, whose bones are softer and more flexible.
• Buckle fracture, also called a torus fracture. One side of the bone is compressed, causing the other side to bend or buckle. This type of fracture also is more common in children due to their flexible bones.

Realigning the bone

If the bone fragments are out of place, your healthcare professional may need to manually move them back into position. This process is called reduction. Depending on your level of pain and swelling, you may need an injection of numbing medicine at the site of the fracture. You may need a muscle relaxant, a sedative or general anesthesia before the procedure.

Immobilization

To heal properly, the bone must not move This is done using a splint, sling, brace or cast.

Before applying a cast, your healthcare professional may wait 5 to 7 days for swelling to go down. During this time, you'll likely wear a splint at all times.

You typically return for X-rays during the healing process to ensure the bone remains in the correct position.

Medicines

To reduce pain and inflammation, your healthcare provider may pain reliever you can buy without a prescription. If your pain is severe, you may need a prescription for pain medicine for a few days.

Nonsteroidal anti-inflammatory drugs, also called NSAIDS, can help with pain. But they may slow bone healing, especially with long-term use. Ask your healthcare professional if you can take them for pain relief.

If the bone has pierced the skin, you may need antibiotics to prevent infection from spreading to the bone.

Therapy

Rehabilitation begins soon after treatment. If possible, gentle movement should begin early to prevent stiffness in your arm, hand and shoulder while you're wearing a cast or sling.

Once the cast or sling is removed, your healthcare professional may recommend rehabilitation exercises or physical therapy to help regain muscle strength, improve joint movement and restore flexibility.

Surgery

Some fractures need surgery to keep the bones stable while they heal. If the bone didn't break through the skin, your healthcare professional may wait until the swelling goes down before doing surgery. To help lessen swelling, you may be told to keep your arm still and raised. And you may be asked to gently move your fingers to prevent stiffness in those joints after they heal.

To hold the bones in place, your healthcare professional may use wires, plates, screws or nails. Complications are rare, but they include infection and slow bone healing.

Depending on the severity of the break, your healthcare professional or your care team in the emergency room may refer you or your child to an orthopedic surgeon. An orthopedic surgeon is a doctor who specializes in injuries affecting bones, joints, muscles, ligaments and tendons.

What you can do

Make a list that includes:

• Details about your or your child's symptoms and the incident that caused them.
• Information about past medical conditions.
• All the medicines and dietary supplements you or your child takes.
• Questions to ask your healthcare professional.

For a broken arm, questions to ask include:

• What tests are needed?
• What is the best course of action?
• Is surgery necessary?
• What restrictions will I need to follow?
• Do you recommend seeing a specialist?
• What pain medicines do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, including:

• What caused the symptoms?
• Did an injury trigger the symptoms?
• How severe are the symptoms?
• What, if anything, seems to improve the symptoms?
• What, if anything, appears to worsen the symptoms?