A broken arm is a common orthopedic injury that requires prompt medical attention. The arm contains three primary bones: the humerus (upper arm), and the radius and the ulna (forearm). Fractures can occur in any of these bones, with distal radius fractures near the wrist being particularly frequent, often after a fall onto an outstretched hand.
Identifying the Immediate Signs
The most telling sign of a fracture is immediate, intense pain at the injury site, which worsens significantly with movement or pressure. This sharp, localized pain indicates that the structural integrity of the bone has been compromised, often leading to a loss of function.
Following the injury, the area will likely swell rapidly. This swelling can be severe and is frequently accompanied by bruising (ecchymosis), caused by damaged blood vessels. A more alarming sign is an obvious deformity, where the arm appears bent, twisted, or angled unnaturally, indicating that the fractured bone segments have shifted out of alignment.
A distinct sensation or sound known as crepitus may be noted upon moving the limb. Crepitus is a grating or crunching noise caused by the rough ends of the broken bone segments rubbing together. If nerve involvement has occurred, the person may experience numbness or tingling sensations in the hand or fingers, requiring urgent assessment.
Stabilizing the Injury and Immediate Care
Once a fracture is suspected, the immediate priority is to stabilize the limb to prevent the broken bone ends from causing further damage to muscles, nerves, or blood vessels. The injured arm should be immobilized in the position it was found; do not attempt to straighten or “reset” the bone, as this can cause severe additional injury. A makeshift splint can be created using rigid materials like rolled-up newspapers or sticks, secured with tape or cloth strips, and extending beyond the joints above and below the fracture site.
The injured arm should be placed in a sling to support its weight and keep it still against the body, which helps reduce movement and pain. To manage swelling and pain, apply a cold pack or ice wrapped in a thin towel to the injured area for 10 to 20 minutes. Elevating the arm above the level of the heart, if possible, will also assist in minimizing swelling by encouraging fluid drainage.
If the bone has broken through the skin (an open fracture), the situation requires immediate emergency medical attention. While waiting for help, cover the wound with a clean cloth or sterile dressing to control bleeding and reduce the risk of infection. Do not touch or attempt to push the protruding bone back beneath the skin. The most important action is to seek emergency medical care promptly.
What to Expect from Professional Diagnosis
Upon arrival at a medical facility, a healthcare provider will conduct a thorough physical examination, visually assessing for deformity, swelling, and bruising, and carefully palpating the area for tenderness and signs of crepitus. They will also perform a neurovascular assessment to check for proper blood flow and nerve function below the injury site. The gold standard for confirming a fracture is imaging, most commonly with an X-ray.
X-rays provide images that clearly show the bone discontinuity, allowing the doctor to determine the fracture’s location, type, and severity. Fractures are classified based on whether the skin is broken (open or closed) and the pattern of the break (simple, complex, or comminuted). If the X-ray is inconclusive or soft tissue damage needs assessment, a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) may be necessary.
Initial treatment involves reduction, the process of realigning the bone fragments into their correct anatomical position. This may be done non-surgically (closed reduction) or require surgery (open reduction). Following realignment, the arm is immobilized with a cast or splint to hold the bones in place, allowing the natural healing process to occur.