Upper & Lower Arm Fractures

what is an upper or lower arm fracture?

The arm consists of three long bones. The humerus connects the shoulder to the elbow and the radius and ulna connect the elbow to the wrist in the forearm.

A fracture is a term used to describe a break in a bone. A fracture can range from a hairline crack through to complete displacement of the bone.  Also a fracture can result in multiple pieces of bone (comminuted). 

An arm fracture refers to a break of one or more bones in the arm.

It is not uncommon for forearm fractures to include both the radius and the ulna.

For Shoulder fractures see (hyperlink shoulder fractures) for elbow fractures (see elbow hyperlink ).

what are the causes?

Fractures of the long bones in the arm are most often caused by:

  • Direct impact or blow
  • Trip or fall onto outstretched arm
  • Sporting accident
  • Fall from a height
  • Motor vehicle accident

Conditions that weaken the bone such as osteoporosis may increase the risk of fracture on injury.

what are the symptoms?

An injury to the bones in the arm that results in a fracture usually causes immediate pain. Movement of the arm will result in sharp pain and the arm may require support to minimise the movement.

Other symptoms might include:

  • Obvious visible deformity – this is most common where the bones no longer align and appear straight, rather will appear bent.
  • Swelling
  • Bruising
  • Inability to move or rotate the arm
  • Numbness or tingling in fingers

how are fractures of the upper and/or lower arm diagnosed?

If you are experiencing any of the symptoms above following an injury to your arm or forearm, you should see your doctor or present to the emergency department.

Your doctor will ask you questions about the nature of your injury and your symptoms. An examination of the shoulder, arm, elbow, forearm and hand will also be performed.

An Xray is usually performed to confirm a fracture to any of the bones in the arm.

A CT (computed tomography) scan may be required if an x-ray does not show the fracture lines clearly or the fracture involves the shoulder joint or elbow joint

A MRI (magnetic resonance imaging) scan may also be done to identify injuries to other structures such as ligaments.

how are arm fractures treated?

Fractures to bones in the arm, particularly the forearm, usually cause immediate pain and will require urgent medical care. 

If the two ends of broken bone are aligned or can easily be manipulated back into place, your doctor may secure the arm with a cast or brace to immobilise the bones. The type of cast or brace and length of time the arm will need to be immobilised will depend on the location and severity of the injury.  Your cast may be changed once the swelling subsides.

Surgery is often required in fractures that involve the upper and lower arm.  Surgery should be considered if:

    • The two ends of the bones are not aligned (displaced) or are at a significant angle to one another. 
    • The fracture involves a nearby joint
    • The bone has pierced the skin
    • Blood vessels or nerves of the arm have also been injured
    • If early movement of the arm is important for a speedy recovery

During surgery, X-rays are performed to ensure that the best possible position of the fracture can be achieved.  Internal rods or plates and screws are used to hold the bones together.

Following surgery the arm may be placed in a back slab, splint, cast or sling for a short period. Your doctor will advise how long the these are to remain in place.

what are the potential complications of a fracture?

    • Infection and wound breakdown
    • Damage to the blood vessels and/or nerves
    • Swelling and stiffness in the joints of the upper and lower arm
    • Prominence of metal work, removal of metal work
    • Failure of fixation – sometimes the bones are not strong enough to be held together with plates, screws or rods.  This will often require further surgery.
    • Nonunion – non-healing of the bone. Factors increasing the risk of nonunion include:
      • Smoking
      • Osteoporosis
      • Diabetes
      • Infection