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Health condition · Clinically reviewed

Broken arm, from humeral shaft to scaphoid, with a plan for each level.

A single label covers many injuries. This guide walks through humerus, elbow, forearm and wrist fractures, the nerves and vessels at risk, and how each is treated in the UK today.

Jump to treatment
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BOA, BOAST and peer-reviewed orthopaedic sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice including fragility fracture pathways, FLS review and pre-contoured plating.

Key facts

Broken arm at a glance.

The essentials, in plain English - the levels involved, the nerves at risk and how UK teams stage treatment.

  • What it means

    A broken arm covers any fracture from the shoulder to the wrist, from the humerus through radius and ulna to the carpal bones.

  • Common patterns

    Proximal humerus and distal radius fractures dominate in older adults, while supracondylar fractures dominate in children.

  • Neurovascular risk

    Radial, median and ulnar nerves and the brachial artery are all at risk depending on the level of the break.

  • First-line imaging

    X-ray in two views covering the joint above and below, with CT for intra-articular or comminuted patterns.

  • Non-operative care

    Many humeral shaft, minimally displaced proximal humerus and undisplaced radial head fractures do well in a sling or brace.

  • Fragility fractures

    A low-energy break in an adult over 50 should trigger a Fracture Liaison Service review, DEXA and bone protection.

Why this guide matters

Not every broken arm is the same.

The three points below shape decisions from the emergency department through theatre and rehab.

  • Level determines pattern and risk

    Humeral shaft fractures threaten the radial nerve. Supracondylar breaks threaten the brachial artery and median nerve. Distal radius fractures threaten function of the hand.

  • Reduction and neurovascular checks first

    Before any splint or plaster, the team documents pulses, capillary refill and nerve function, then rechecks after any manipulation.

  • The plan finishes with rehab

    A well-fixed fracture with poor rehab still ends in stiffness. Hand therapy and physiotherapy are part of the treatment, not an optional extra.

How the diagnosis is made

From the emergency door to a clear plan.

The steps a UK trauma team will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Open fracture and life threat check

    Any open wound over a fracture triggers the Gustilo-Anderson pathway with tetanus cover, early antibiotics and urgent surgical wash-out.

  2. 02

    Assessing

    Neurovascular assessment

    A structured check of radial pulse and capillary refill, plus radial, median and ulnar nerve motor and sensory function before and after any splinting.

  3. 03

    Assessing

    Two-view X-ray

    AP and lateral films covering the whole bone and the joints above and below, with oblique views for the scaphoid or radial head where indicated.

  4. 04

    Confirming

    CT for complex patterns

    Intra-articular distal humerus, distal radius, comminuted olecranon and coronoid fractures usually need CT to plan fixation.

  5. 05

    Confirming

    MRI for occult and soft tissue

    MRI is the best test for a clinically suspected but X-ray negative scaphoid fracture, occult radial head fracture, avascular necrosis or ligament injury.

  6. 06

    Preparing

    Compartment syndrome vigilance

    Forearm compartment syndrome presents with pain out of proportion, pain on passive stretch and the classic six Ps, and needs urgent fasciotomy.

  7. 07

    Preparing

    Fragility fracture pathway

    Low-energy fractures in adults over 50 trigger Fracture Liaison Service referral, DEXA, vitamin D check and consideration of bone-protection therapy.

Typical timeline: from the emergency department to a definitive plan within hours, and to theatre within 24 hours for open or unstable injuries.

Symptoms

What a broken arm actually looks like.

The classic mix of pain, swelling, deformity and loss of function - plus the signs that make an injury an emergency.

  • Pain, swelling and bruising

    Immediate pain with rapid swelling and deep bruising around the break, often tracking down the arm with gravity.

  • Deformity and shortening

    Obvious angulation, rotation or a step in the bone, sometimes with shortening compared with the other side.

  • Loss of function

    Inability to move the shoulder, elbow or wrist, or to lift or grip because of pain and mechanical instability.

  • Focal bony tenderness

    Point tenderness over the fracture site, often with crepitus felt on gentle movement.

  • Reduced range of motion

    Guarding and stiffness in the joints above and below the break, with a springy end feel in dislocations.

  • Nerve symptoms

    Numbness, tingling or weakness in a radial, median or ulnar distribution suggesting nerve involvement.

  • Cold, pale or pulseless hand

    A cool or dusky hand with a weak or absent radial pulse points to vascular injury and needs emergency review.

  • Red flag - open wound over bone

    Any break in the skin near a suspected fracture is an open injury until proved otherwise and needs urgent orthopaedic care.

Treatment

How a broken arm is treated in the UK.

Sling, brace or cast for most stable patterns, and modern fixation for the injuries that need it. Every plan finishes with rehab.

  • Sling and functional brace

    Many humeral shaft fractures heal well in a U-slab converted to a Sarmiento functional brace over about three months, with regular X-ray review.

  • Broad arm sling

    Undisplaced proximal humerus, radial head Mason I and stable clavicle-adjacent fractures often need only a short sling with early guided motion.

  • Cast or splint immobilisation

    Distal radius, forearm and scaphoid fractures with acceptable alignment are treated in a moulded cast, usually for six to eight weeks with interval X-rays.

  • Closed reduction and K-wires

    Displaced paediatric supracondylar and some distal radius fractures are reduced under anaesthetic and pinned percutaneously to hold the position.

  • ORIF with plates and screws

    Open reduction and internal fixation with pre-contoured locking plates is the workhorse for distal radius, forearm, olecranon and complex proximal or distal humerus fractures.

  • Intramedullary nail

    A humeral or forearm nail can stabilise selected shaft fractures, pathological fractures or polytrauma patients where load sharing and early motion matter.

  • Joint replacement

    Hemiarthroplasty or reverse total shoulder replacement for complex three or four-part proximal humerus fractures, and total elbow replacement for selected distal humerus fractures in older adults.

  • Structured hand and physio

    Every plan finishes with hand therapy and physiotherapy for range of motion, oedema control, grip and graded return to work, sport and driving.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your orthopaedic surgeon or emergency clinician knows your injury and your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Fractures (complex): assessment and management (NG37) and Fractures (non-complex): assessment and management (NG38).

  • British Orthopaedic Association Standards for Trauma (BOAST). Open fractures, supracondylar fractures of the humerus in children, and distal radius fractures.

  • Royal College of Emergency Medicine. Best practice guidelines for suspected scaphoid injury and compartment syndrome.

  • National Osteoporosis Guideline Group (NOGG). Prevention and treatment of osteoporosis and the Fracture Liaison Service model of care.

Red flags

When a broken arm needs urgent attention.

Most upper limb fractures are handled in a routine trauma pathway. These are the situations that are not, and where a specialist opinion or emergency care is needed.

  • Open fracture

    Any wound over a suspected fracture is an emergency. Cover with a saline-soaked dressing, splint, give antibiotics and tetanus, and refer for urgent surgical debridement.

  • Compartment syndrome

    Escalating forearm pain, pain on passive finger extension, tense swelling or the six Ps needs emergency fasciotomy within hours to save the limb.

  • Vascular injury

    A cold, pale or pulseless hand after a supracondylar or displaced elbow fracture is a vascular emergency needing urgent reduction and vascular review.

  • Nerve palsy

    Radial nerve palsy with a distal third humeral shaft (Holstein-Lewis) fracture, or median or anterior interosseous nerve deficit in supracondylar injury, needs documentation and specialist review.

  • Suspected scaphoid fracture

    Anatomical snuffbox tenderness after a fall on an outstretched hand should be splinted and reimaged or scanned even if the initial X-ray looks normal.

  • Pathological fracture

    A break after minimal trauma, night pain, weight loss or a known cancer history needs urgent imaging and oncology or metabolic bone review.

  • Fragility fracture in an older adult

    A low-energy proximal humerus or distal radius fracture should trigger Fracture Liaison Service referral, DEXA and bone-protection review.

  • Non-accidental injury in a child

    Unexplained, multiple or metaphyseal corner fractures in young children need safeguarding review alongside orthopaedic care.

  • Signs of infection

    Increasing redness, wound discharge, fever or worsening pain after surgery or open injury needs same-day review to exclude deep infection.

Recovery

From cast off to back to what you love.

Four things that make the biggest difference through the weeks and months of recovery from an upper limb fracture.

A quiet reminder

Return to activity is graded, not sudden.

Most people are back to light activity by six weeks, driving between six and twelve weeks, and full sport or heavy work between three and six months depending on the injury.

  1. 01 Early days

    Rest, ice, elevate and move fingers

    For the first week, keep the arm elevated above the heart, ice for twenty minutes at a time and move the fingers, thumb and shoulder to prevent stiffness and swelling.

  2. 02 Weeks 2 to 6

    Follow the review schedule

    Interval X-rays check alignment and healing. Do not skip follow-up, and let the team know early if the cast feels tight or something changes.

  3. 03 Rehab

    Hand therapy and physiotherapy

    Guided range of motion, oedema management and graded strengthening make the difference between a stiff arm and a functional one.

  4. 04 Long term

    Bone health and prevention

    If this was a low-energy fracture, ask about calcium, vitamin D, DEXA and bone-protection medicines. Falls prevention matters just as much as the drug.

Frequently asked

Everything we get asked about broken arms.

Quick answers on humerus, elbow, forearm and wrist fractures, and what recovery really looks like.

  • What counts as a broken arm?

    Any fracture of the humerus in the upper arm, or the radius or ulna in the forearm, counts as a broken arm. In everyday use it also includes wrist and hand fractures like the distal radius, scaphoid and boxer's fifth metacarpal fracture. Each level has its own patterns, complications and treatment ladder.

  • Do I always need surgery for a broken arm?

    No. Many humeral shaft fractures, undisplaced proximal humerus fractures, stable radial head fractures and well-aligned distal radius fractures heal in a sling, brace or cast. Surgery is reserved for open injuries, unstable or displaced patterns, intra-articular fractures, neurovascular injury and pathological fractures.

  • How is a child's broken elbow treated?

    A displaced supracondylar humerus fracture is a common paediatric injury classified by Gartland. It is usually treated with closed reduction and percutaneous K-wire pinning under anaesthetic, with careful checks of median nerve, anterior interosseous nerve and brachial artery function. Open reduction is reserved for irreducible or vascular injuries.

  • What is a scaphoid fracture and why is it different?

    The scaphoid is a small carpal bone with a fragile blood supply. A fall on an outstretched hand can fracture it and cause anatomical snuffbox tenderness. Even if the initial X-ray looks normal, a suspected scaphoid injury is splinted and re-imaged or scanned because a missed fracture risks non-union and avascular necrosis.

  • What is compartment syndrome and how urgent is it?

    Forearm compartment syndrome is a surgical emergency where swelling inside a closed muscle compartment cuts off circulation to muscle and nerve. Warning signs include pain out of proportion to the injury, pain on passive finger stretch and a tense, hard forearm. It needs urgent fasciotomy within hours, and every splint or cast is loosened while awaiting review.

  • I broke my arm from a simple fall. Should I worry about my bones?

    Yes. A low-energy fracture in an adult over 50 is called a fragility fracture and is often the first sign of underlying osteoporosis. You should be referred to a Fracture Liaison Service for DEXA scanning, vitamin D and calcium review, falls assessment and consideration of bone-protection medicines to reduce the risk of the next fracture.

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