The information here will help you understand your forearm injury, guide you through your rehabilitation and explain what you can do to maximise your recovery.
Advice for a recent forearm injury
In the first 72 hours, it’s important to:
- rest your forearm
- elevate your arm using a pillow, cushion or sling
- apply a cold pack regularly
- protect your limb by wearing your sling and plaster cast
It’s helpful to remember PRICER:
The Emergency Department (ED) or a Minor Injuries Unit (MIU) may have prescribed you with some pain relief. Take these as instructed to help manage the pain.
If you do not feel that this medication is helping, talk to us during your appointment in Fracture Clinic, or your GP, about an alternative option.
Ice is a great natural anaesthetic that helps relieve pain and controls swelling. Apply ice packs or a bag of frozen peas wrapped in a wet thin towel to your injured area for up to 15 minutes every few hours.
- Do not place ice in direct contact with the skin.
- Do not leave the ice pack on for more than 20 minutes at a time in one hour.
Rest and elevation
It’s important to rest your injured area as much as possible in the first 24 to 72 hours.
It’s normal to experience swelling after your injury which is often worse at the end of the day.
Elevation reduces swelling, which in turn relieves pain and speeds up your healing. Keep your injured area elevated as much as possible during the first 24 to 72 hours.
If you have been given a sling, use it to keep your injured area elevated. You may find it more comfortable to use pillows to elevate it during the evening and at night.
If you have a lower limb injury, try to keep your feet elevated above the level of your hip.
Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. Stopping smoking during the healing phase of a fracture will help ensure optimal recovery from this injury.
For advice on stopping smoking and local support available, please discuss this with your GP or go to the NHS Smoke Free website.
Helping your recovery
Being healthy can help you recover from your injury faster. Eating well, staying hydrated and keeping as active as possible will all help. We’ve put together a set of videos on all the things you can do to help you recover as quickly as possible.
The information below will help you understand your injury, guide you through your rehabilitation and explain what you can do to maximise your recovery.
Your diagnosis should have been made by an orthopaedic consultant or one of the team working under the supervision of the consultant team. The information in these care plans is to help you understand your diagnosis and is not exhaustive.
Non-urgent advice: Please note:
Your consultant may give you a different, personalised care plan based on your injury and whether you need imaging (x-ray, CT scan, MRI, or an ultrasound) or an operation.
Midshaft forearm fracture
What is your injury?
You have broken a bone or multiple bones in your lower arm. These injuries commonly happen during a collision or high energy fall.
It normally takes 12 to 16 weeks to heal.
Forearm fractures have a higher risk of not healing properly, especially if you smoke.
Complications of forearm fractures
Compartment syndrome is a rare but potentially serious complication of forearm fractures. It’s caused by bleeding or swelling within an enclosed bundle of muscles – known as a muscle compartment. It causes intense pain, especially when the muscle is stretched. Read more about compartment syndrome on the NHS website.
The bones in the forearm may not heal properly. They may:
- take longer than normal to heal – known as delayed union,
- heal in an abnormal position – known as malunion. Malunion can cause functional impairment,
- not unite back together – known as non-union.
Smoking can lead to longer healing times and smokers are at twice the risk of experiencing non-union, especially if they have an open fracture.
Forearm fractures can also cause damage to nerves or blood vessels.
You’ll see a member of the orthopaedic team in the first 2 weeks after your injury. You might need a further x-ray or we may give you another cast. The doctor will explain the next stage of your recovery and tell you if you need an operation.
You can also book an open appointment at any time in the 6 months after your injury. Please call 01736 758892 to make an appointment.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow this rehabilitation plan
- you have any questions
- you’re struggling with your sling
- you notice pain in an area other than your forearm.
If you need an operation
In some cases you may need an operation to realign your bones. This may involve putting plates, screws or rods inside your arm. Sometimes we may need to use a temporary external frame.
Your surgeon will discuss the benefits and risks of surgery so you can make an informed decision about whether to have the operation.
What are the risks with surgery?
If you’re overweight, smoke or not active, you’re at greater risk of developing complications after surgery. It may take longer to recover.
Possible complications that you should be aware of include:
- scarring on the arm
- damage to tendons, nerves or blood vessels
- infections, which we can treat with antibiotics
- further surgery if wounds become more deeply infected
- nerve pain (in rare cases) which may need further treatment
- further surgery if the fracture is not stable or does not heal properly.
Most complications are minor and can be treated easily and successfully.
How long will I spend in hospital after my operation?
Forearm surgery patients generally go home the same day. You may need to spend one night in hospital.
After surgery you’ll need to strictly rest and elevate your arm. You can expect to be up and active within 48 hours. Your surgeon will tell you more about this.
Managing your injury after surgery
For the first 6 weeks you may need a sling to protect your arm, help support you and manage swelling. Stop using the sling as soon as it feels comfortable to do so. This will help you avoid a stiff elbow.
You can find out more about having an operation on our surgery for fractures and soft tissue injuries page.
Early movement and exercises
Start the exercises below as soon as possible. You can move your shoulder and neck as normal to stop them becoming stiff.
It’s important that you can always move your fingers and have full feeling in your hand. If you lose movement or feeling, go to the emergency department immediately.
Exercises to do immediately
Do these exercises every day. They’ll help you regain any loss of movement
Moving your fingers
Complete the exercises labelled “Hand exercises 1“.
Moving your shoulder
You can move your shoulder as normal. Try to move it daily to help your shoulder stay mobile.
Moving your neck
Complete the exercises labelled “Neck exercises“. Repeat this a few times every day.
Exercises to do when your cast has been removed
Complete the exercises labelled “Elbow exercises 2“. Do these exercises 3 to 4 times a day, 10 times each.
You can find out more about your injury, and see demonstrations of the exercises in this video from Brighton & Sussex University Hospitals.
Your sling and plaster cast
Using your sling
Wear your sling during the day for up to 6 weeks. You can take it off to wash, dress and exercise. You don’t need to wear it at night.
Once your plaster has been removed, stop using the sling as soon as it feels comfortable to do so. This will help you to gently mobilise the elbow so it doesn’t become stiff.
You can see more about how to fit your sling, and washing, dressing, sleeping and sitting with your sling in these videos.
If you’re struggling with your sling, please call the Fracture Clinic on 01872 253091 and we’ll be happy to give you advice.
Your plaster cast
We may put your arm in a plaster cast to encourage healing and good alignment.
Keep your cast clean and dry. You can find out more about caring for your plaster cast here.
If you have significant problems with your cast, please call the plaster room on 01872 253234 or attend ED out of office hours.
How to manage your forearm after the cast has been removed
We recommend that you:
- soak your arm in warm water if it’s swollen or it aches
- massage it regularly with oils or hand cream directed towards your elbow
- elevate your hand and arm on pillows if they feel swollen and keep your fingers moving
- keep your shoulder and wrist moving to reduce stiffness
- use your wrist, hand and arm as normally as possible when we tell you to do so
Caring for your wound and stitches
If you’ve had an operation, you’ll need to keep your stitches dry and clean. You should also look out for any redness or signs of swelling, bleeding or pus as these can be signs of an infection.
You can find information about how to care for your stitches, if/when they need to be removed and signs of an infection on our surgery for fractures and soft tissue injuries page.
Blood clots and Deep Vein Thrombosis (DVT)
Because your limb is immobilised and you’ll be moving less than normal, you’re at higher risk of developing a blood clot or Deep Vein Thrombosis (DVT). This can be life threatening if left untreated.
Symptoms of DVT in the leg are:
- throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
- swelling in 1 leg (rarely both legs)
- warm skin around the painful area
- red or darkened skin around the painful area
- swollen veins that are hard or sore when you touch them.
These symptoms can also happen in your arm or tummy if that’s where the blood clot is.
More information about DVT
- Watch this video about how to prevent DVT.
- Learn more about DVT including symptoms, who is at risk and how to treat it.
- Find out how to reduce the risk of blood clots when you have an immobilised lower limb (PDF, 108 KB).
Preventative medication for DVT
If you have been told not to put any weight through your leg or to partially weight bear (50%), you should have been assessed in ED or MIU and told if you need to take preventative medication.
If you have not had this conversation please call your GP for an urgent appointment.
Depending on your injury, you may have been prescribed a course of a blood thinner. There are a few different types of medication and they often need injecting into your tummy. You can discuss an alternative with a doctor. Please see the relevant care plan for your injury.
Pressure sores and ulcers
Wearing a boot or plaster cast combined with not moving your limb can lead to pressure sores or ulcers. These are injuries to the skin and underlying tissue caused by prolonged pressure, rubbing or tension.
They often develop gradually, but can sometimes form in a few hours.
Signs and symptoms of pressure sores
- skin discolouration – red patches for people with pale skin, purple or blue patches for people with dark skin
- discoloured patches that do not turn white when pressed
- a patch of skin that feels warm, spongy or hard
- pain or itchiness in the affected area.
If you have a boot, take it off every day to check your skin and make sure it’s not rubbing.
If you have a plaster cast, look out for a change in colour (red or white) of your skin above or below the plaster, an increase in pain inside the plaster or pins and needles.
- Watch this video to learn how to prevent pressure sores.
- Read more about pressure sores on the NHS website.
If you think you have a pressure sore or ulcer call the Fracture Clinic straight away on 01872 253091.
For out of hours advice please call 01736 758909.
Sepsis (also known as blood poisoning) is a serious infection that can be life threatening. There is no one sign for sepsis so it can be hard to spot.
Call 111 immediately if you develop any of the following:
- Slurred speech or confusion
- Extreme shivering or muscle pain
- Passing no urine in a day
- Severe breathlessness
- It feels like you’re going to die
- Skin is mottled or discoloured.
Find out more about the symptoms of sepsis on the NHS website.
These videos also explain what sepsis is and how to spot the early signs.
Living with your injury
Decisions to return to work are made on a unique basis and should be discussed with the Fracture Clinic, your GP and your employer.
You may need time off work and when you return, you may need light or amended duties. When you should return to work will depend on your profession and your injury.
You can get a fitness to work statement or a sick note when you come into the Fracture Clinic. If you don’t need to come and see us, you can get one from your GP.
Wait at least two weeks after your injury or surgery. After that, you can return to driving when:
- you have been told you no longer need your sling
- we’ve removed your cast (if you had one)
- you’re able to turn the steering wheel comfortably and without any pain
- you can control the vehicle safely
- you’ve checked it’s okay to drive with your insurance company.
Always test your ability to drive with the ignition off and in a safe environment.
If you have a follow-up appointment with us, please wait until your consultant or physiotherapist has given you clearance to drive. If you are in any doubt, do not drive until you have spoken to our team.
You should not do any sports or heavy lifting for at least 12 weeks, but possibly longer, depending on your injury.
Thank you to Brighton and Sussex University Hospitals for kindly letting us use information from their care plans to create this site.
Page last reviewed: 9 May 2023