Broken arm question

It was one of the two bones in his arm that got broken, right? Broken in two places.

Not his fingers? Not his wrist? Not a compound fracture? No nerve damage? no muscle damage accompanying the break? Not something fancy with his elbow?

If this is the case, he shouldn't have any problem wriggling his fingers at any time, right from the start.

When they put the cast on one of the first things they have the patient do is wiggle his fingers to make sure the cast fits right and isn't rubbing them when they move.

Just because I have never seen it written in such a way and it would be cool, but sometimes when you break a bone they don't cast you, they only put it in a sling. It depends on where the break is. Lots more mobility, but because the muscle is always working it is sore a lot more often and it can impact healing time.

He would be able to wiggle his fingers.

The two bones in the lower arm are the [SIZE=-1]radius and ulna. If both of these bones were completely broken, you won't wait a day to get it cast. Your wrist would basically be flopping. However, if one of these bones was only cracked, you could wait a day.

Trauma that breaks both the [/SIZE][SIZE=-1]radius and ulna is usually going to be pretty severe. If only one is broken, you need a lot less casting (the other operates as a partial splint). And depending on how severe, the possibility of one bone being broken in two places and waiting a day is a possibility.

[/SIZE][SIZE=-1]Lower down, if you break bones in your wrist, you can wait a day easily. I know. Broke a bone in my wrist, finished the last 20 mile bike ride, and only went in the next day at the strong suggestion of my wife. I could use my fingers both before and after casting. Never missed a beat with them.

All of these fractures would still leave you your fingers. It would take a lot to get your fingers splinted completely.

Best of luck,

Jim Clark-Dawe

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Breaking of the radius near the wrist, often involving the ulna as well, is a common fracture--called a Colles' fracture. It happens when someone falls on an outstretched arm. It does not require a large amount of force. In general, fractures are often not put in a cast right away because there is too much swelling; they are splinted and cast later when the swelling goes down. And yes, you would be able to wiggle your fingers; if you can't, that is a real danger sign that there is nerve entrapment.

I shattered both wrist bones and was put in a cast within hours. I could wiggle my fingers but not my thumb. The thumb took a couple of physio courses to get it moving, approximately 8 weeks.

I broke my lower radius in high school. The coach put an air splint on my arm and iced it. It didn't hurt that bad but I still Iwent into shock a little bit--light headed, touch of nausea.

The doc put it in a cast and a sling that afternoon. Gave me a little something for the pain, but it felt okay, I could move my arm, my fingers, etc. I think I had the cast for 6 weeks. Had it replaced once, after it got wet...

Have to throw in my "I dun broke my arms, too" shot. I was twelve and playing Superman when I fell from a harness and broke the radius in one arm and the ulna in the other. HAd a full arm cast for me right and a partial for my left and still managed to hold third chair in guitar class. Ya, I'm as brilliant now as I was then.

Pike

Shady Lane said:

I've never broken a bone, so I'm in the dark here.

My character broke his arm. He got it casted the day after the injury. Now, two weeks later, can he wiggle his fingers.

The bone was broken twice, both below the elbow. He didn't need surgery.

Click to expand...

If that is all the info to go on you can do it any way you want. Proper Casts immobilize at least the joints on either end of the fracture. However in young people with greenstick fractures you might see a short arm cast in a distal wrist fracture where they immobilize the thumb as well. Did he wait a day on his own (frightened, drugged out, on the lam, in shock) or was he seen by someone who wasn't sure (mild fracture without bone displacement, or so swollen that it was misdiagnosed as an infection and referred) and had him see a specialist the next day?

IF all is well your character should be wiggling fingers but if there has been swelling inside a confined space of a cast it could be damaging nerves, maybe even a compartment syndrome and loose wiggling ability.

The less you say about the specifics, the more leeway you have in your story

Depending on age. If the break is below the elbow, then it will be a forearm cast which if it is mid radius/ ulna (The bones of the forearm) it will not include the joint and the sling will be low slung for 2 - 3 days then the arm with the cast will be allowed to hang free.

If treatment is delayed, as you mention, for a day- Then hospitalisation is inevitable and recovery will be slower. He undoubtedly will have to have the arm surgically re-broken so the bones can be aligned before the cast is applied. He will have to have considerable rehabilattion. (see below)

You can move your fingers immediately, in fact the patient must move the fingers to retain flexibility, blood flow and prevent swelling.

The cast will remain on for 4 -6 weeks by then the bone should have healed. Casts are frequently made from fibre glass and can a lot of punishment.

If the patient is a child the treatment is similar but is considerably more serious. Due to the still growing bones and stuff.

I note that you say it is double break. That I take to mean that both ulna and radius are fractured. In which case surgery is necessary to stabilise both bones. Hospitalisation will probably be for 3 -4 days post op to ensure there is no complications like nerve and vessel damage.

If only one of the bones is fractured but in two place then the above holds true, but a pin and plate will be needed to stabilise the fracture and this again requires surgery and hospitalisation will be about 7 - 9 days. Rehabilitation will start about 6 weeks post op and will take sometime.

It takes a considerable force to break a bone, so a compound fracture (multiple breaks) is very serious. If the fracture breaks the skin (known as a complicated/ communuted fracture) this is very serious as it usually leads to infection.

In any case the patient will have to take a course of antibiotics (10 days, 1- 2 tablets three time per day) usually flucloxicillin 500 milligrams so the dose is 1 - 3 grams daily, also the victim will be in considerable pain for 2 - 3 weeks and would have to have Paracetamol / Codeine Phosphate or similar drug combination.

You will have to check with a local doctor for specifics but the treatment is standard in all first world counties and in larger centres in third world countries.

I hope this helps. I was a Critical care nurse for many years if you are concerned about the veracity of the information.