Hand, Wrist & Upper Limb
Radius and Ulna Shaft Fracture
Non-Operative & Operative management
About Your Injury
This injury involves a break in the shaft (middle section) of the radius, the ulna, or both forearm bones. In adults these fractures are usually treated with surgery, but in select cases — particularly minimally displaced fractures, or isolated ulna shaft fractures with acceptable alignment — non-operative treatment in a cast is appropriate.
Non-Operative Management
Forearm shaft fractures can often be safely and effectively managed without surgery, particularly isolated ulna fractures or minimally displaced injuries. The decision is individualised to each patient, based on patient factors (age, comorbidities, occupation) and specific characteristics of the fracture (location, displacement, rotational alignment).
Recovery Timeline
Weeks 0–1
Above-elbow cast or splint, elevation, and swelling control.
Weeks 1–2
Early repeat X-ray, as forearm fractures can displace in the first 1–2 weeks.
Week 6
X-ray to confirm healing; cast removed, followed by gradual return of elbow, forearm, and wrist movement.
Week 12
Confirmation of healing and return to sport.
3–4 months
Return to full contact sport.
Follow-Up Schedule
1–2 weeks
Clinical review and repeat X-ray to check for early displacement.
6 weeks
X-ray to assess healing progress and remove the cast.
12 weeks
Confirmation of healing and return to sport.
Operative Management
Displaced fractures, or those involving both bones, are usually treated with surgery to restore length, rotation, and alignment — factors that are difficult to control reliably in a cast.
A plate and screws are used to fix the fractured bone. If both the radius and ulna are fractured, each is fixed with its own plate; if only one bone is fractured, a single plate is used. This stable fixation is strong enough that a cast or splint is not required afterward. The procedure is performed under general anaesthetic, with local anaesthetic infiltration at the time of surgery for good pain control in the first 12–24 hours afterward, and is usually done as day surgery or with a single overnight stay.
Recovery Timeline
From surgery
No cast or splint is needed — gentle movement of the elbow, forearm, and wrist can begin early, as guided by your surgical team.
2–3 weeks
Driving usually resumes around this point.
12 weeks
Return to full activity, including contact sport, once the fracture is confirmed united on X-ray.
Follow-Up Schedule
2 weeks
Wound check and review of movement and function.
6 weeks
X-ray to assess healing progress.
12 weeks
X-ray to confirm union before clearing full activity and contact sport.
Hardware Removal
Plates are rarely removed. Removal is only considered if hardware becomes symptomatic — for example, causing local irritation or discomfort.