Broken arm (arm fracture)

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

An arm is broken when a direct or indirect force splits bones in the upper or lower arm into two or more parts. A broken arm can be open or closed, simple or complicated. Pain and restricted mobility accompany the injury. Read here how to provide first aid for a broken arm and the special features of a broken arm in children.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. S42S52

Brief overview

What to do if you have a broken arm Immobilize the arm, cool it if necessary (closed arm fracture) or cover it with sterile (open arm fracture) depending on the fracture, call an emergency doctor, calm the patient down
Arm fracture risks: accompanying injuries to tendons, muscles, ligaments, etc. as well as complications (including circulatory disorders)
When to the doctor In order to avoid possible permanent misalignments and restricted mobility as well as complications, you should always see a doctor with a broken arm.

Caution!

Never try to "straighten" a broken arm with a misalignment!
Avoid moving a broken arm if possible, and make sure that the person concerned is also holding the arm still. Otherwise, the injury could worsen
If the wound is bleeding profusely in the case of an open arm fracture, attempts should be made to squeeze off the corresponding vessels. However, you are not allowed to apply a pressure bandage in the case of or on a fracture!

Broken arm: what to do

A broken arm is very painful for those affected and restricts the mobility of their arm. With an open arm fracture, the sight can also be terrifying because the soft tissue above the fracture is injured and parts of the bone may be visible in the open wound. As a first aider, you should therefore try to calm the person down first. The other first aid measures are:

Put the affected arm still, e.g. by padding it with a rolled up jacket or blanket. If necessary, you can also fix the arm with a triangular shawl.
In the case of a closed arm fracture, you can carefully cool the likely existing swelling with a cold pack or ice pack (do not place it directly on the skin, but with a layer of fabric in between!).
Especially with an open arm fracture, the sight of the exposed bone can shock the person concerned. Then bring him into the shock position (flat supine position with legs raised).
In the event of an open arm fracture, cover the wound with a sterile pad. This prevents the penetration of germs and thus a wound infection.
Talk to the injured person and explain each first aid step to him. That creates trust and calms you down. If any touch or movement causes painful sounds, painful twitching, or the like in the person concerned, then stop what you are doing.
Call emergency services or take the injured person to the hospital.

If a joint (such as the wrist) is broken, it makes no difference to first aid. Treat this injury as you would a “normal” broken bone.

Broken arm in the child

Romping around, jumping, climbing or racing down the slopes on skis - it's easy for a child to break an arm (or get another injury). A broken arm in a child is different from that in an adult. One reason for this is the skin around the bone, the so-called periosteum. It is still very elastic in children. If the child breaks his arm, the periosteum usually remains undamaged and holds the fragments together. Since a young, green branch kinks in a similar way, doctors also call such a break a greenwood fracture. It usually heals well. However, if the growth plates are damaged, this can disrupt the child's bone growth and lead to misalignments.

In general, however, cross breaks in children heal fairly quickly (faster than in adults) because they are still growing. Therefore, conservative treatment is usually sufficient.

Broken arm: risks

Possible risks and complications from a broken arm include:

Concomitant injuries: Most of the time, not only does the bones break, the skin, tendons, ligaments or muscles, and possibly nerves and blood vessels, are also damaged. The doctor must treat these injuries as well.
Humeral head necrosis: It can occur when the head of the humerus has broken. The bone tissue in this area dies because certain blood vessels are injured and the bone is no longer supplied with sufficient blood.
Compartment syndrome: Here swelling and bruising cause a dangerous increase in pressure in a muscle box (group of muscles surrounded by a barely stretchable fascia). The increased pressure affects the blood flow to the muscle tissue, so that it can die. A compartment syndrome must therefore be operated on as soon as possible!
Pseudoarthrosis: If six months after the arm fracture the ends of the bones have not grown back together properly, but are still flexibly connected, doctors call this pseudoarthrosis. It can be painful and restrict arm mobility. Usually an operation is then necessary.

Broken arm: when to see a doctor?

Anyone who has broken an arm always needs medical help! Because without treatment, the ends of the bones may grow together incorrectly and the function of the arm may remain permanently restricted.

Especially with the so-called Monteggia fracture, a forearm fracture including dislocation, it is easier to set the radial head if the doctor can do this promptly. In this case, a specialist in orthopedics and trauma surgery is the right contact.

Broken arm: medical examinations

In the event of a broken arm or a corresponding suspicion, the doctor will first obtain important background information (anamnesis) in conversation with the patient or first aider. For example, he can ask:

How did the accident happen?
Do you have pain and is the mobility of your arm restricted?
Have you already had complaints, illnesses (e.g. osteoporosis) or restricted mobility?

This anamnesis discussion is followed by a physical examination. The doctor carefully feels the arm and looks to see if he can detect any soft tissue damage. It also checks the blood circulation, motor skills and sensitivity of the arm.

In order to be able to determine with certainty whether an arm bone is broken, imaging procedures are necessary: In adults, the affected arm is X-rayed. In the case of children, however, doctors usually carry out an ultrasound examination so that they do not unnecessarily burden the small patients with the X-rays.

More detailed imaging is possible using computed tomography (CT) or magnetic resonance imaging (MRI). Such elaborate examinations can be useful, for example, if a complicated arm fracture or an arm fracture with accompanying injuries to tendons, ligaments or nerves is suspected.

Additional tests may be required, such as electromyography (EMG) - a neurological test of electrical muscle activity in the injury area.

Forms of broken arms

The examinations help the doctor determine the exact type and location of the armbreak. For example, the spoke in the forearm can be broken (broken spoke). If the spoke near the wrist is broken, it is called a wrist fracture, also known as a "distal radius fracture". It is very common in adults, especially those with osteoporosis (bone loss).

You can find out more about the causes and treatment of this injury in the article Wrist fracture.

Osteoporosis patients are also quite prone to fracture of the head of the humerus. The humerus head is the rounded end of the humerus near the shoulder.

You can read everything you need to know about this form of arm fracture in the article humeral head fracture.

In addition to the spoke mentioned above, the second forearm bone (ulna) can also break. Such an ole break can happen in different places. If the fracture line runs near the elbow joint and this joint is also dislocated, a so-called Monteggia fracture is present.

You can find out more about this form of dislocation fracture in the article Monteggia fracture.

Broken arm: treatment by the doctor

The aim of therapy for a broken arm is to make the bone resilient as soon as possible. Depending on the type and severity of the armbreak and the general health of the patient, the doctor can treat conservatively or surgically:

Conservative treatment: The doctor aligns the ends of the fracture and immobilizes the arm with a cast, splint or brace.
Surgical treatment: the doctor has different options depending on the fracture and accompanying injuries. For example, he can fix the broken ends in the desired position with nails, wires or plates.

If an arm breaks, it usually takes about six weeks to heal.

Prevent arm breakage

Preventing a broken arm is not easy because it usually happens through events that are difficult to control. This could be a fall while skiing or cycling, falling down stairs, slipping on the icy sidewalk or a car accident. Also, if you are hit by a heavy falling object, a broken arm can result.

General caution is most likely to prevent such accidental injuries. For example, you should be focused and attentive in traffic (regardless of whether you are driving, cycling or pedestrians). Adhere to the safety rules and pay attention to where you step when walking and running (e.g. on stairs or in rough terrain). Wear suitable shoes and use walking aids if necessary. You should avoid high-risk sports if possible or at least wear the recommended protective equipment. For example, when mountain biking or inline skating, forearm guards can prevent you from ending up in hospital with the diagnosis “broken arm”.

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