Broken Arm Overview
A broken or fractured arm means that one or more of the bones of the arm have been cracked.
This is a common injury occurring in both children and adults. In adults, fractures of the arm account for nearly half of
all broken bones. In children, fractures of the forearm are second only to broken collarbones.
Basic anatomy: The arm consists of 3 major bones.
The humerus runs from the shoulder to the elbow. This is called the upper arm, or, simply, the arm. At the elbow, the humerus
connects with 2 bones: the radius and the ulna. These bones go from the elbow to the wrist and are regarded as the forearm.
Important terms related to a broken arm
Alignment: The relationship
of how the broken portions of the bone come together. This is an indication of how badly a bone is broken.
Angulation: The angle formed
by the broken pieces of bone. Another measure of the seriousness of the break.
Closed fracture: A broken bone
without an open skin wound
Comminuted fracture: A bone
that is broken in multiple pieces
Dislocation: A bone that has
come out of a joint
Displaced fracture: A broken bone with the parts of the bone not aligned
Fracture: A crack in the bone.
This is another word for a broken bone.
Fracture-dislocation: A broken
bone that has also come out of a joint
Greenstick fracture: An incomplete
fracture seen in children where only one side of the bone is broken
Malunion: Healing of the bone
in an unsatisfactory position
Nonunion: Failure of the pieces
of bone to heal back together
Occult fracture: A broken bone
that does not appear initially on the x-rays
Open fracture (compound fracture):
A fracture that has a laceration in the skin overlying the break or a fracture that has a piece of bone sticking through
Pathologic fracture: A broken
bone that is due to a weakness of the bone itself from some other disease
Most broken arms have these symptoms:
A large amount of pain and increased pain when
moving the arm
Maybe an obvious deformity compared to the other
Possible open wound either from the bone puncturing
the skin or from the skin being cut during the injury
Decreased sensation or inability to move the
limb, which may indicate nerve damage
When to Seek Medical Care
Call your doctor after an accident if these signs are present:
Significant pain that is not relieved by ice
and home pain medications such as acetaminophen (Tylenol) or ibuprofen (Motrin)
A large amount of swelling or mild deformity
of the arm compared to the opposite arm
Significant pain with use or limited use of
the affected arm
Pain in one specific part of the arm when it
Your doctor may advise you to go directly to a hospital's emergency
department. Under the following conditions, go directly to the hospital for emergency care:
Visible bone sticking out through the skin
Heavy bleeding from an open wound
Complete lack of movement or sensation of part
of the arm
Obvious deformity that looks drastically different
from the usual appearance
Loss of consciousness
Many other injuries
Exams and Tests
The initial evaluation by any physician,
in the office or in the emergency department, begins with a thorough history and physical exam. By finding out the details
of the accident, the doctor is able to determine what damage was done based on the mechanism of the trauma.
After taking a history, the physician will do a complete physical exam with special
focus on the painful areas. The doctor is looking for signs of a fracture (such as swelling or deformity) and checking for
possible nerve or blood vessel damage.
X-rays are typically the test used
to assess for broken bones. At least 2 views of the arm are taken. Initially, most broken bones will have an apparent fracture
or other abnormality on the x-ray. Some fractures are not always visible on the first set of x-rays. In those instances,
a CT scan or MRI may be done immediately for further evaluation, or follow-up x-rays may be obtained at a later date.
Broken Arm Treatment
Self-Care at Home
The most important aspect of first aid is to stabilize the arm. Do this by using a towel as a sling. Place it under the arm and then around the neck. An alternate
approach to keep the arm from moving is to position a rolled and taped newspaper along the swollen area and to tape it in
Apply ice to the injured area. This can help
to decrease pain and swelling. Place ice in a bag and leave it on the arm for 20-30 minutes at a time. It may be helpful
to place a towel around the ice bag or in between the bag and the skin to protect the skin from getting too cold. Never put
ice directly on the skin.
The most important aspect of treating fractures is to determine which ones can be treated with outpatient
care and which require admission to the hospital.
In most instances, the
broken arm will be able to be treated in the emergency department.
Most fractures will need to have a splint or
partial cast applied to stabilize the broken bones. Some breaks especially in the upper arm and shoulder may only need to
be immobilized in a sling.
In addition to splinting the broken arm, the
physician will prescribe medicines for pain control and ice to decrease swelling.
Typically, wounds that warrant admission to
the hospital are these:
Bones that have gone through the skin or have
lacerations over the broken area
Fractures that are associated with nerve damage
Fractures that are associated with blood vessel
Complicated fractures that have multiple breaks,
involve the joints, or are unable to be stabilized in the emergency department or doctor’s office
arms will not require admission to the hospital. For all other fractures, the treating doctor will suggest you follow up
with an orthopedic doctor (bone specialist). At that time, the orthopedist will determine what further care (continued splinting,
casting, or surgery) is necessary based on the type of fracture.
follow-up instructions for fractures include the following:
Wear any support device (splint, sling, or brace,
for example) until the doctor sees you for follow-up.
Keep your splint or cast clean and dry.
Apply ice to the injured area for 20-30 minutes
4-5 times a day.
Keep your arm elevated above the heart as much
as possible to decrease swelling. Use pillows to prop your arm while in bed or sitting in a chair.
Take pain medicine as prescribed. Do not drink
or drive if you are taking narcotic pain medication.
Call your doctor for increased pain, loss of
sensation, or if your fingers or hand turn cold or blue.