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I don't suppose asking you this now is going to make a difference but I still want to know. Our daughter who is 14 now and interested in playing tennis on her high school team has discovered she can't fully turn her palm up. That could keep her from the tennis team. She did break that arm when she was eight but has never had any problems until now. Could this be coming from the old fracture? Is there anything that can be done?
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Children often fall and break their arms. The forearm with its two bones (radius and ulna) is one of the most common childhood fractures. Most of the time these types of breaks are clean and simple. The physician can line the bones back up without surgery.
The child wears a splint or cast for four to six weeks while the bone remodels and heals. And quite honestly, if the child has not yet completed his or her full growth and has not yet reached skeletal maturity, the bone does a remarkable job healing and even restoring normal anatomy.
But there are those cases we call bad actors: problematic forearm fractures that require recognition and special treatment. In the simplest of cases, the bones are displaced (separated). There may be a hidden dislocation along with the fracture that doesn't show up on a plain X-ray.
Or there could be a fracture with bone rotation so the ends no longer line up as they should. Putting the arm in a cast without realigning the bones could result in permanent loss of wrist and forearm motion. Sometimes one or both of the bones break and leave the bone at an angle. This type of deformity won't realign on its own. To add to that list, there could be cases where the forearm fracture affects the alignment of the elbow. It sounds like this may be the case for your daughter.
It's important to make sure the child has full forearm rotation before considering the case closed. It's all too easy for a child with limited forearm movement to make up the loss by compensating with the wrist and shoulder. The loss of forearm rotation (palm up and palm down) may not be evident until years later when they start to participate in sports and can't move as needed. This could be the case for your child.
It is possible that soft tissue restrictions are contributing to the problem and could respond to conservative care. A physical therapist can mobilize the soft tissue and joint in an effort to restore normal movement. The therapist can check to see if there are compensations in the shoulder and address those as well. It may be a simple matter of teaching your daughter some stretches or other exercises she can do to gradually restore full motion.
Corrective surgery may be needed if the desired range-of-motion cannot be gained. Even with surgery, there is a risk that with soft tissue scarring and shortening, full motion won't be possible with corrective surgery. At this point, an orthopedic surgeon will be able to advise you. Some imaging studies (e.g., X-rays, CT scans, MRIs) may be needed to complete the clinical assessment and provide you with a potential treatment plan.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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