A broken arm or wrist is usually caused by a fall or by force from a collision. 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. However, most people use the word 'fracture' to describe a crack rather than a clean break. This article will use the terms 'break' and 'crack' to describe both.
If you think you may have broken or cracked a bone in your arm, or you think your child has, go to your nearest hospital 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 cracked or broken arm 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
If it's just a crack in the bone, you may think the pain and swelling have just resulted from a sprained or torn tendon (read about sprains and strains). Getting the arm X-rayed in hospital is the only way to confirm whether or not the bone has been injured.
If it's a clean break, you may have heard a snap or a grinding noise during the accident. The bone may have broken straight across or diagonally, or may be a spiral (winding) break. In severe cases, the arm bone may stick out at an angle or poke through the skin.
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) that day.
Before going to hospital, you can stabilise the arm by using a towel as a sling (this goes under the arm and then around the neck). Don't try to straighten the arm.
Take an ice pack with you to hold to the injured area - try a bag of frozen peas wrapped in a tea towel. This can help to 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, as your child may feel very distressed.
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 (see box on this page for an explanation of key medical terms). Even if it's just a cracked bone (called a hairline fracture), this should still show up faintly on X-ray.
If it's a minor break or crack, your doctor will just apply a plaster cast to the arm or wrist to hold the broken ends together while they heal. This is called closed reduction, as no incisions are needed. It may be done using a local or regional anesthetic, where the arm is numbed and you don't feel any pain (this is rarely used in children), or using a general anaesthetic, where you are put to sleep.
For more severe fractures, an operation may be necessary to bring the bones together. This involves cutting open the skin (open reduction) using a general anaesthetic and fixing the bones using pins, rods or a plate and screws.
Once the bones have been aligned and the arm or wrist has been bandaged and set into a plaster cast, the arm will be secured to the chest with a sling. Plaster may not be needed if the bones are held in position with a metal fixation device.
Recovering from a broken arm or wrist
The plaster cast will usually need to stay on for a few weeks, the time it takes for the bone to heal.
The exact length of healing time depends on the type of fracture, whether it has damaged the surrounding tissues, and (to an extent) the age of the patient. For example, a young child who has cracked their bone at the 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.
When the cast comes off, the arm or wrist should have healed and it can be used normally, although it may be stiff.
However, children who have just come out of plaster are at risk of breaking or cracking their bone again, so it's worth keeping them away from trampolines, bouncy castles, soft play areas and contact sports for a further two to three weeks to minimise this risk.
Physiotherapy is sometimes needed for adults after the bone has healed, to help build up strength in the arm muscles and restore full movement. However, this is rarely needed for children.
A broken arm bone that has pierced the skin and damaged the surrounding tissue may become infected, so the wound will need to be cleansed regularly.