Common Fractures of the Arm and Wrist

Physical Therapy Management

What are the most common upper extremity fractures that your physical therapist may treat in the clinic?

A fracture can be a painful thing. Fractures occur when a traumatic force is applied to the bones in the body and the bones are unable to tolerate the force. There are many ways that trauma can cause a fracture. Sports injuries, automobile accidents, and falling can all cause a bone to break. Fractures of the arm are most commonly caused by falling on your outstretched arm or on your shoulder, known as a FOOSH injury.

If you suspect you have suffered a fracture of the arm, elbow, or the wrist you must consult with your doctor or local emergency department. The initial treatment for a fracture is for your doctor to reduce the fracture by putting the bones in the proper position. This can be accomplished manually or by a surgical procedure depending on the severity of your fracture.

After reduction, the fractured arm must be immobilized to ensure proper healing can take place. Immobilization is achieved with a cast or brace. Sometimes you may be required to wear a sling while your arm fracture heals. You may require the services of a physical therapist to learn how to properly size and wear your sling.

Physical therapy for an arm fracture usually starts after the cast or brace has been removed. The most common goals after an arm fracture are to decrease pain and swelling and to restore normal range of motion, strength, and function in the arm.

Fractures of the arm, wrist, and elbow are all treated by physical therapy professionals. Some common arm and upper extremity fractures are listed below.

1

Collar Bone (Clavicle) Fracture

The collarbone, or clavicle, is the bone that attaches the shoulder joint to the breastbone in the front of your chest. Fracture of the collarbone usually occurs with trauma, such as falling on your shoulder or during athletic activity. Sometimes, an open reduction with internal fixation is required to fully reduce a clavicle fracture. Physical therapy for a collarbone fracture involves restoring normal range of motion and strength to your shoulder and upper arm muscles.

2

Proximal Humeral (Upper Arm Bone) Fracture

Painful shoulder conditions may need physical therapy to help return to normal.
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The proximal humerus is the part of your upper arm bone that is near your shoulder. A fracture can occur here if you fall on your shoulder or fall onto your outstretched hand. Some proximal humeral fractures heal with rest and immobilization, while severe fractures of the humerus require surgery to stabilize. You will likely need to wear a sling on your arm after a proximal humeral fracture.

Physical therapy after a proximal humeral fracture involves improving shoulder and arm range of motion and regaining normal strength in your shoulder and arm.

3

Elbow Fracture

Man holding his elbow.
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The elbow joint is made up of the union of three bones: the humerus (upper arm bone) and the radius and ulna (the bones of the forearm). A fall onto the elbow can cause a fracture of one, two, or three of these bones. Restoring normal range of motion after an elbow fracture is difficult, so physical therapy is an important component of your elbow fracture rehabilitation.

4

Colles' fracture

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A Colles' fracture is a break in the forearm near the wrist. The bones of the forearm usually are pushed towards the back of your arm in a Colles' fracture, and surgery may be necessary to fix the problem. If the bones are pushed towards the front of your forearm, it is called a Smith's fracture. Both are caused by falling on your outstretched arm and hand.

5

Boxer's fracture

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A boxer's fracture is a break in one of the bones of your hand that make up your knuckle. This type of fracture is usually caused by punching or striking a hard object with a closed fist. A boxer's fracture is sometimes called a brawler's fracture.

If you have suffered a boxer's fracture, your PT can help you restore normal hand and upper extremity function once the fracture heals.

A Word From Verywell

If you have suffered an upper extremity fracture, check in with your doctor, and then visit a physical therapist to regain full mobility in your shoulder, arm, and wrist

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