Fractures of the shaft of the radius and ulna are referred to as “both bones forearm fractures”. These injuries usually occur as a result of a direct blow to the side of the forearm. They are more common in children than adults, especially during contact sports. In children under 10 years of age, the primary treatment is closed reduction (setting the bone without making an incision) and casting. Children between 10 and 15 are in a grey zone because younger children have a huge potential to remodel while this potential decreases as one approach skeletal maturity.
Forearm fractures in adults are almost always treated with surgical repair. Non-operative management leads to poor outcomes with loss of wrist rotation and diminished grip strength in the involved hand. Alignment and anatomic length of both bones is critical for wrist function as the radius rotates around the ulna. If left untreated, displacement or shortening of the radius results in marked limitation of rotation of the wrist. Treatment involves realigning the bones and securing them with a plate and screws. Surgical repair takes can be performed as an outpatient. After surgery, patients wear a splint for about 2 weeks and then begin a fairly aggressive protocol with physical therapy to regain range of motion in the forearm. Recovery is usually quick and most patients regain full function within 8-12 weeks after surgery.