Forearm Fractures

The interosseous membrane and strong forearm muscles cause displaced fragments to shorten and rotate. Plaster casts cannot maintain alignment against these forces, and malunion produces permanent limitation of forearm rotation. Children, whose bones have greater remodeling potential, can often be managed in casts; adults cannot.

Yes. The elbow X-ray is mandatory after any forearm fracture to identify an associated radial head dislocation (Monteggia). The elbow may not be painful despite joint disruption.

In adults, plates are generally left permanently unless they cause symptoms. Plate removal is an elective procedure typically not performed before 18–24 months post-fixation.

Bone healing typically takes eight to twelve weeks after plate-and-screw fixation of a forearm fracture, though early controlled motion of the wrist and elbow usually begins within the first one to two weeks. Regaining full forearm rotation (pronation and supination) can take three to six months and depends greatly on the quality of fracture reduction and commitment to rehabilitation. Your MOS surgeon will coordinate care with a hand therapist to maximize your functional recovery.

Most patients regain excellent forearm rotation after well-aligned surgical fixation, but some permanent loss is possible, particularly after comminuted (multi-fragment) fractures or those involving the radial head. Malunion — healing in a twisted or angulated position — is the most common reason for lasting rotational loss, which is why precise fracture reduction during surgery is so important. Physical therapy including progressive forearm rotation exercises is an essential part of recovery to maximize the rotation you regain.