Forearm fracture fixation is an operation to realign and stabilise fractures of both the radius and ulna bones in the forearm using plates and screws. Both bones must be accurately restored to allow normal forearm rotation.
Separate incisions are made over the radius (front of forearm) and ulna (back of forearm). Each fracture is reduced and fixed with a contoured plate and screws. Restoring the exact curvature of the radius is critical for rotation. The operation takes one and a half to two hours.
Almost all displaced forearm fractures in adults require surgery. The radius and ulna must rotate around each other for normal forearm function, and any malalignment significantly impairs rotation.
Undisplaced fractures may be managed in a cast. In children, many forearm fractures remodel and can be treated non-operatively. In adults, displaced fractures almost always require surgery.
Standard pre-assessment. Surgery usually within days.
Restoration of forearm alignment and rotation. Union rates exceed 95% with plate fixation. Most patients regain good forearm rotation and grip strength.
Some loss of full pronation or supination is common.
Two incisions produce visible scars.
Expected for several weeks.
Rare formation of a bony bridge between the radius and ulna, blocking rotation. Risk approximately 2-3%.
Failure of one or both fractures to heal.
Posterior interosseous nerve (radius) or sensory nerves at risk.
A surgical emergency. More common in high-energy injuries.
If plates are removed after healing.
Wound infection.
General or regional anaesthesia.
A splint for comfort for one to two weeks. Active forearm rotation begins early. Return to desk work at two to four weeks. Manual work at eight to twelve weeks. Full recovery three to six months.
X-rays at two weeks, six weeks, and three months.
Most patients regain 80-90% of normal rotation. Some loss is common but rarely causes functional problems for daily activities.
Not routinely. Forearm plates are only removed if they cause problems. However, in young active patients, removal may be discussed after confirmed healing.