Fracture Care · Elbow, forearm & wrist
Both-bone forearm fracture
Both-Bone Forearm Fracture (Radius and Ulna) — Open Reduction and Internal Fixation (ORIF)
The condition
The forearm has two long bones, the radius and the ulna, that work together to let you turn your palm up and down. A both-bone forearm fracture breaks both, usually from a fall or a direct blow. In adults these breaks are unstable and tend to heal poorly in a cast, so surgery is usually recommended.
The surgery
This is a typically outpatient surgery through two incisions on the forearm. Each bone is lined up and held with a metal plate and screws, restoring its length and gentle curve so the forearm can turn normally. If the joint at the wrist or elbow is also injured, it is stabilized at the same time. The final plan is determined during surgery.
Recovery at a glance
- Splint
- Splint and elevation for 10–14 days. Finger motion right away (make a full fist every hour); a removable wrist splint for comfort until 6 weeks.
- Motion
- Elbow, wrist, and forearm turning exercises start when the splint comes off; regaining palm-up and palm-down rotation is a priority.
- Daily life
- Desk work and typing often within 1–2 weeks. Lift only 1–2 lb (a coffee cup) for 6 weeks. No driving while taking narcotic pain medication.
- Bone healing
- Healing is checked on x-ray at ~6 weeks. Lifting up to 5 lb until 8 weeks, then weight through the hand and strengthening progress.
- Activity
- Full release typically ~3 months; contact sports once the bones have healed (typically 3–4 months).
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring alignment gives the best chance of healing and regaining forearm rotation and strength. Risks are uncommon and include infection, blood clots, delayed or failed bone healing, hardware irritation that may require removal, loss of forearm rotation, bone bridging between the two bones (rare), compartment syndrome (dangerous muscle swelling; rare), injury to nearby structures (such as nerves or blood vessels), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery