Proximal radius fracture – Royal Sussex County Hospital and Princess Royal Hospital

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(No Follow-up appointment)

What is this information about?

This information is about proximal radius fracture.

It tells you:

• How to look after yourself when you go home from hospital with a proximal radius fracture
• What exercises you can do to help heal and strengthen your arm
• What follow-up treatment you might have
• Who to contact if you need further help and support.

What is a proximal radius fracture?

This is a break to the top, or near the top (near your elbow) of the radius bone. The radius is one of the two long bones in your forearm.

Do I have a fracture or a break?

If you have a fracture, it means you have a broken bone. ‘Fractured bone’ and ‘broken bone’ both mean the same.

How long is it likely to take for my injury to heal?

It usually takes 6 weeks for a proximal radius fracture to heal. You may still have mild stiffness or not be able to fully straighten your elbow after 6 weeks. This is unlikely to cause you any problems. All other movements should return to what they were before your injury.

Will smoking or vaping slow down my healing? 

Yes. Smoking slows healing so if you smoke or vape try to stop or cut down. This is most important in the first 2 weeks after your injury. If you would like help to stop smoking talk to your GP or visit Quit smoking – NHS  for further information.

What should I do if I am in pain after my proximal radius fracture? 

If you are in pain, take your usual pain killers or pain killers given to you in the emergency department. Follow the dose instructions on the packet. If you are struggling with pain do speak to your GP or pharmacist.

When should I be wearing my sling?

Your sling should be worn for comfort in the first 2 weeks. You can take it off to wash, dress and to do your exercises. It does not need to be worn at night. Try to come out of the sling as soon as possible.

What should I do if I am struggling with my sling?

What must I do if the feeling (sensation) in my fingers changes? 

Some people may get pins and needles (tingling) especially in their fourth (little) and third (ring) fingers. Moving your fingers and thumb may help.

If:

• the sensation gets much worse in your fingers
• you completely lose feeling and/or you are unable to move your fingers

Please contact the Virtual Fracture Clinic (see contact details at the end of this information) or come to A&E if it is outside of normal working hours (Monday to Friday from 8am to 4pm).

When should I start exercising?  

Elbows get stiff quickly. It is important to start your exercises as soon as possible. You can do light activities when your pain has settled. It may take 3 months to regain 80% of your normal movement but you should be able to return to your daily activities by this point. Improvements can continue for 6 months, but you may always have a slight restriction when trying to get your elbow straight. This is not something that will need surgery.

Will I have further (follow up) appointments?  

No. We do not usually follow up patients with this type of injury as they heal well.

Your pain should gradually improve over time. If you are still struggling at 6 weeks post injury, please get in touch with us to discuss. If your pain is manageable but your injury is still a concern at 12 weeks post injury, please contact us.

What should I do in the first 6 weeks after my injury?

• Rest your arm for the first 24 to 72 hours (1 to 3 days). However, it is important to keep moving your fingers, wrist, and shoulder, so they do not get stiff. Do this gently, without causing too much pain.
• Apply cold packs (ice pack or frozen peas wrapped in a damp towel) to the sore area for up to 15 minutes, every few hours. This can provide short-term pain relief.

• Take your arm out of the sling and practise moving your elbow. It is important to move your elbow regularly throughout the day. Aim to practise all the exercises every hour, or at least 3-4 times a day. Repeat each exercise 10 times. These exercises should not cause too much pain. Reduce how much you do them if they make your pain worse.

Finger and wrist bending and straightening

1. Open and close your hand as shown. Then move your wrist up and down.
2. After a few days move on to hold a soft ball or a ball of socks. Squeeze the ball as hard as you can without it causing you pain. Hold for 5 seconds.

Elbow Bend to Straighten

3. Bend and straighten your elbow as far as you can. Do not push into pain. You may feel a mild to moderate stretch. You can use your other arm to help if necessary.

Forearm Rotations

4. Keep your elbow at your side and bent to 90 degrees (a right angle) so your arm is in an L shape by your side. Slowly turn your palm up and down. You may feel a mild to moderate stretch but do not push into pain. You can use your other arm to help if you need to. 

What should I do from week 6 after my injury? 

Your fracture should be healed around 6 weeks after your injury. When you feel ready and your pain has settled, you can start to lift more and gradually return to sports. It is normal to still have mild discomfort so be guided by this. The discomfort may continue for 3-6 months.

When can I return to work?

If you have a desk-based job or similar, you can return to work as soon as you feel confident to do so, providing you follow the advice in your care plan. If you have a more active or manual job, you may need a fit note until you are able to return to your normal duties.

When can I return to lifting and sports?

Avoid bearing weight through the arm for 6-8 weeks and avoid sports for 4-6 weeks. Activities with higher risk such as skateboarding should be avoided for at least 6 weeks. Be guided by your symptoms and return to lifting and normal activities as your pain and movement allow.

What other things can the Virtual Fracture Clinic help me with?

Please contact the Virtual Fracture Clinic if you:

• are concerned about your symptoms
• are struggling to return to exercise or your usual activities
• would like further information or support after you have read this information.

When can I start driving? 

You can return to driving when you:

• are no longer using your sling
• can turn the steering wheel as much as you need to without pain
• can safely deal with all emergency situations without being in pain or hesitating. For example, you must be able to stop the car quickly and in full control and safely avoid obstacles
• are covered by your insurance company.

How can I get a fit note for work?

You can get a fit note from the Virtual Fracture Clinic team.

If contacting by phone, please leave a message with your date of birth, name and clear contact details, along with a brief message about what problems you are having.

We will contact you back as soon as possible.

We aim to get back to you within 24 hours.

Contacting us by email would be preferable as the phone line can be very busy.