Common forearm fractures in adults

Fractures of the forearm are common injuries in adults. Proper initial assessment includes a detailed history of the mechanism of injury, a complete examination of the affected arm, and appropriate radiography. Open fractures, joint dislocation or instability, and evidence of neurovascular injury are indications for emergent referral. Fractures demonstrating significant displacement, comminution, or intra-articular involvement may also warrant orthopedic consultation. In the absence of these findings, many forearm fractures can be managed by a primary care physician. Initial management of forearm fractures should follow the PRICE (protection, rest, ice, compression, and elevation) protocol, with the exception of compression, which should be avoided in the acute setting. Distal radius fractures with minimal displacement can be treated with a short arm cast. Isolated ulnar fractures can usually be managed with a short arm cast or a functional forearm brace. Mason type I radial head fractures can be treated with a splint for five to seven days or with a sling as needed for comfort, along with early range-ofmotion exercises. Patients with an olecranon fracture are candidates for nonsurgical treatment if the elbow is stable and the extensor mechanism is intact.