Both-Bone Wrist Fracture (Distal Radius & Ulna)

Description

This is a break of both forearm bones — the radius and the ulna — near the wrist. It is a common combination after a fall onto an outstretched hand, because both bones take the force together.

How it happens (the mechanism)

A fall onto the hand loads the wrist end of both forearm bones at once, in the soft metaphyseal zone where children’s bones give way most easily. Because both breaks sit close to the wrist’s active growth plates, they share the same generous ability to remodel and straighten with growth — so near the wrist, two broken bones behave much like one.

Symptoms

Pain, swelling, and a bend or bump near the wrist, with reluctance to use the hand.

Doctor examination and imaging

The doctor checks alignment and the hand’s circulation and feeling; X-rays from two angles show both fractures and their position.

Treatment

A cast is the mainstay. If the bones are tilted or shifted, they are gently set back into place first. Surgery is occasionally needed for a very unstable break, but most heal well without it. A few early X-rays confirm the bones stay aligned, since two-bone breaks can occasionally drift in the cast.

Recovery and long-term outlook

Like other wrist-area breaks, these heal well and remodel as the child grows, usually within four to six weeks.

When to call the doctor

Call the office right away if your child’s fingers become numb, pale, blue, or cold; pain keeps worsening even after raising the arm and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Forearm Fractures in Children: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.