Broken arm or wrist 

  • Overview

Introduction 

Useful terms

  • humerus – bone between the shoulder and elbow
  • radius – bone between the elbow and wrist (thumb side of the arm)
  • ulna – bone between the elbow and wrist (little-finger side of the arm)
  • simple or closed fracture – an easily treated break with little damage to the surrounding tissue
  • compound or open fracture – a complicated break with damage to the surrounding skin
  • comminuted fracture – the bone has broken into several pieces
  • hairline fracture – a minor crack to the bone, which only shows up faintly on X-ray

A broken arm or wrist is usually caused by a fall onto an outstretched arm. It takes about six to eight weeks to heal in adults, and less time in children.

Doctors refer to all breaks or cracks in bones as fractures.

If you think you or your child has broken a bone go to your nearest accident and emergency (A&E) department. If the injury is severe, dial 999 for an ambulance.

How can I tell if the arm or wrist is broken?

A broken arm or wrist bone will be extremely painful and there may also be:

  • swelling or tenderness around the injured area
  • bleeding, if the bone has damaged the tissue and skin

These symptoms may also occur if your arm or wrist is sprained rather than broken (read about sprains and strains). An X-ray in hospital is the only way to confirm whether or not the bone is broken.

If it's a clean break, you may have heard a snap or a grinding noise during the accident. The bone can break straight across, diagonally, or in a spiral pattern.

In severe cases, the bone may break into many pieces (comminuted), stick out at an angle or poke through the skin (open or compound fracture).

What you can do

It's important not to eat or drink anything if you think you've broken your arm, as you may need a general anaesthetic (be put to sleep) to allow doctors to realign the bone.

Before reaching a hospital, a sling may help stabilise the arm (this goes under the arm and then around the neck). Avoid trying to straighten the arm.

Applying an ice pack to the injured area (try a bag of frozen peas wrapped in a tea towel) can help reduce pain and swelling.

If your child has injured their arm or wrist, try and get someone else to drive so you can support and comfort them.

How a broken arm or wrist is treated

A broken arm or wrist is usually treated in a hospital accident and emergency department. The treatment differs depending on the severity of the injury.

First, a doctor will give you or your child painkillers and then fix a splint to the arm to secure it in position and prevent further damage.

An X-ray will be taken of the arm to see what kind of fracture it is. Even hairline fractures should show faintly on X-ray.

A simple fracture where the bone remains aligned can be treated by applying a plaster cast. This holds the broken ends together so they can heal. You will be provided with painkillers to take home and information on how to look after your cast. An appointment will be made to attend a fracture clinic so specialist orthopaedic doctors can take over the care of your fracture.

With more severe arm or wrist fractures, the bones can become misaligned (displaced). If the bone is not realigned (reduced), the bones will not heal well. Doctors can use a technique called 'closed reduction' to pull the bones back into position.

Local or regional anesthetic will be used to numb the arm (this is rarely used in children), or you will be put to sleep using a general anaesthetic. If doctors are happy with the bones' new position, you may be treated with a plaster cast and regular follow-up appointments and X-rays.

Certain fractures are best treated with surgery to realign and fix the broken bones. This includes displaced fractures, fractures involving a joint, and open fractures. Surgeons can fix bones with wires, plates, screws or rods. This is called open reduction and internal fixation (ORIF). Any metalwork is usually not removed unless it becomes a problem.

In rare cases an external frame is used to hold the broken bones, known as an external fixator.

After most surgery, a plaster cast is applied to protect the repair. A sling may also be provided for comfort. If you have surgery, you will usually be able to go home within a day or two.

Recovering from a broken arm or wrist

The plaster cast will stay on until the bone has healed. The exact length of healing time depends on the type of fracture, whether it has damaged the surrounding tissues, and the age of the patient. For example, a young child who has cracked their wrist will need to wear a cast or removable splint for just two to three weeks. But in older people, a wrist injury can take a lot longer to get back to normal and stiffness is extremely common. 

It's important not to get a plaster cast wet – read How should I care for my plaster cast? for more advice.

The orthopaedic doctors will decide when you can take the cast off and when you can return to normal activities or work.

Your arm is often stiff and weak after being in a cast. Physiotherapy can be useful to help build up strength in the arm muscles and restore full movement. However, this is rarely needed for children.

The risk of re-breaking or cracking the bone once the plaster is removed is increased, especially in children. It is advisable for children to avoid trampolines, bouncy castles, soft play areas and contact sports for a further two to three weeks to minimise this risk.

You should not drive while in a cast. Seek advice from your doctor about when you can drive again.




Page last reviewed: 12/02/2013

Next review due: 12/02/2015

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