Overview
Fractures of the distal radius (wrist) are the most common forearm fracture in children. Boys are more commonly injured than girls.
Signs of a broken arm or wrist include: pain and tenderness, bruising, swelling and loss of movement in the hand or arm. The wrist or arm may be out of shape.
What to Do
If you think your child has broken their arm or wrist:
- go to your nearest accident and emergency (A&E) departmentor call 999 for an ambulance if it’s a bad break – minor fractures can often be treated at a local minor injuries unit
- avoid moving the affected arm as much as possible – it may help to support it in a sling that goes under the arm and around the neck; find out how to make an arm sling
- stop any bleeding by applying pressure to the wound with a clean pad or dressing if possible
- apply an ice pack (such as a bag of frozen peas wrapped in a tea towel) to the injured area if one is easily available
- KEEP THE CHILD FASTING (No food or Drink)
- Where possible try to get someone else to drive so you can support and comfort your child en route to the hospital.
At the Hospital
On arrival in the emergency department the child will be given pain relief and the arm will be x-rayed.
The nerves that supply the hand and wrist will be assessed.
If the wrist is very deformed there will be an attempt to straighten it before placing it in a cast or back slab.
Many of these fractures just require a splint or a cast for a number of weeks.
Those which are more severe may require surgery to stabilise the bones using metal wires.
Care Advice During Recovery
The cast will need to stay on until the broken bone has healed. This usually takes 6 weeks.
While the arm is in a cast:
- avoid putting weight or strain on the arm. Don’t stop moving it completely but avoid activities such as carrying anything heavy, cycling and sports.
- keep the cast dry and the arm elevated (for example, on pillows) whenever possible – read more about how to care for a plaster cast
- contact fracture clinic (in hours) or Accident and Emergency out of hour for cast problems (too loose, too tight or cracked)
- do some gentle exercises and stretches to reduce stiffness – your doctor or a physiotherapist will advise you about this; see an NHS leaflet on getting your hand moving after a wrist fracture (PDF, 170kb) for examples of exercises to try
- seek medical advice if you notice changes in skin colour, pain or sensation in the arm or wrist or if signs of infection (redness, swelling or smelly discharge) develop
Your child should be able to attend school or an appropriate childcare setting while in their cast unless advised against this by your doctor.
They can also advise about when your child can gradually return to sports and other normal activities.
The wrist may be stiff and weak after the cast is removed. This is very normal. Children are able to restore a normal range of movement in their injured arm usually very quickly, however should they require additional assistance physiotherapy can be arranged.