Introduction
A broken arm or wrist is usually caused by a fall onto an outstretched arm. It typically 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.
Go to your nearest accident and emergency (A&E) department if you think you or your child has broken a bone. If the injury is severe, dial 999 for an ambulance.
If it feels like only a minor fracture and it is not an emergency, it may be more appropriate to go to a minor injuries unit.
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 because you may need a general anaesthetic so that the bone can be realigned.
Before reaching hospital, a sling may help stabilise the arm (this goes under the arm and around the neck). Avoid trying to straighten the arm.
Applying an ice pack, such as a bag of frozen peas wrapped in a tea towel, to the injured area can help reduce pain and swelling.
If your child has injured their arm or wrist, try to 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.
A doctor will give you or your child painkillers and fix a splint to the arm to secure it in position and prevent further damage. An X-ray of the arm will then be taken to see what kind of fracture it is. Even hairline fractures 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'll be given painkillers to take home and be told 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 isn't realigned (reduced), the bones won't heal well. Doctors use a technique called "closed reduction" to pull the bones back into position.
Local or regional anaesthetic will be used to numb the arm (this is rarely used in children), or you'll be put to sleep using a general anaesthetic. If doctors are happy with the bones' new position, a plaster cast will be applied and you'll have 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 isn't usually removed unless it becomes a problem.
In rare cases, an external frame, known as an external fixator, is used to hold the broken bones in place.
After most types of surgery, a plaster cast is applied to protect the repair. A sling may also be provided for comfort. You'll usually be able to go home within a day or two of having surgery.
Recovering from a broken arm or wrist
The plaster cast will need to stay on until the bone has healed. The length of time it will take to heal will depend on the type of fracture, whether it's damaged the surrounding tissues, and the person's age.
For example, a young child who's cracked their wrist will need to wear a cast or removable splint for just two to three weeks. However, in older people, a wrist injury can take much longer to heal and stiffness is very common.
A useful rule of thumb is that the time taken for the bone to regain full strength is usually the same as the time it takes for the fracture to heal. That is, if you’ve been in plaster for six weeks, it will take six weeks to regain full strength.
It's important not to get a plaster cast wet. Read more about how should I care for my plaster cast? for further information and advice.
The orthopaedic doctors will decide when you can take the cast off and when you can return to work and normal activities.
Your arm may be stiff and weak after being in a cast. Physiotherapy can help build strength in the arm muscles and restore full movement. However, it's rarely needed for children.
The risk of re-breaking or cracking the bone after the plaster cast is removed is increased, particularly in children. Children should avoid using trampolines, bouncy castles, soft play areas and playing contact sports for a further two to three weeks to minimise this risk.
Adults shouldn't drive while their arm is in a cast. Ask your doctor for advice about when you can drive again.
Credits & Documentation references
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