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Glendale, CA 91206
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When our son was 11-years-old, he had an injury on the soccer field that left him with both bones of the left forearm broken. Fortunately, he is right-handed. But the reason I'm writing now is that he is 21-years-old and seems to have some kind of hand tremors. Could those be from the broken bones even though it's 10 years later?

There aren't very many long-term (10 years or more after the injury) studies of forearm fractures -- especially fractures that involve both forearm bones (the radius and the ulna). But there is one from a medical center in The Netherlands that offers some information that might be helpful. There were 71 patients in the study divided into two groups: those who were skeletally mature and anyone who had not reach full bone growth (skeletally immature). The groups were also analyzed based on different treatment approaches used. The cause of fractures varied but included car accidents, falls, fireworks explosion, crush injuries, and industrial accidents. (There was no mention of soccer or other sports injuries). Slightly less than half of the total group had other injuries as a result of the trauma. There were other bones broken and/or nerves damaged. Everyone was followed for an average of 21 years. The range of years in terms of follow-up was from 13 to 33 years. Age range at the time of follow-up was from 19 years old up to 81 years old. Exact ages at the time of the fractures were not mentioned in this article but from the information provided, there were children, teens, and some adults. Treatment was either with a cast (immobilization) or surgery. Surgery consisted of making an incision, straightening the bones, and holding them in place with a metal plate and screws. The surgical procedure is called open reduction and internal fixation (ORIF). A few patients had external fixation without an open incision. External fixation means that pins are placed through the skin above and below the fracture site. There is a metal rod between the two pin sites. There were some complications after treatment. Some occurred early on while others were reported years later. The most common problem was loss of reduction (already mentioned). After that were wound infections (especially along the pins holding the bones in place), and osteomyelitis (bone infection). Delayed bone healing, nonunion (failure of bone to knit back together), and refracture of the bones are other post-treatment problems that can develop. One patient developed a syndrome of symptoms (pain, stiffness, skin changes) diagnosed as complex regional pain syndrome. There was no mention of finger, hand, wrist, or forearm tremoring. This type of symptom could be benign (have no particular meaning and not part of some other problem). If there is tremoring in both hands, then it could still be considered benign or it might be an early symptom of a neurologic problem separate from the fracture history. This might be something he will want to have a medical evaluation for. Early diagnosis of some neurologic problems can aid in managing symptoms and preventing progression of the disease. If there's nothing to worry about, that bit of information would be helpful, too.


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