Home Trauma & Fracture CareRadius and Ulna Fracture Fixation (Forearm Fracture Surgery) in India

Radius and Ulna Fracture Fixation (Forearm Fracture Surgery) in India

Surgical treatment of broken forearm bones (radius and ulna) using plates, screws, or intramedullary nails to restore alignment and enable proper healing

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Overview

Dr. Gurudeo Kumar is Bihar's leading expert in complex forearm fracture management, having successfully treated over 450 radius and ulna fractures at Arthoscenter Patna with a 97% union rate and excellent functional outcomes. His expertise spans simple isolated fractures to complex both-bone forearm fractures, Monteggia and Galeazzi fracture-dislocations, and comminuted high-energy injuries. The radius and ulna are the two parallel bones in the forearm connecting elbow to wrist. Forearm fractures are extremely common injuries, accounting for approximately 45% of all adult fractures and over 50% of pediatric fractures. They typically result from falls on outstretched hand (FOOSH injuries), direct trauma in motor vehicle accidents or assaults, sports injuries especially in contact sports, or high-energy trauma. Both-bone forearm fractures (involving both radius and ulna) are particularly challenging because the forearm must maintain proper rotational alignment to preserve pronation-supination motion essential for daily activities. Even small degrees of malunion can result in significant functional impairment and loss of forearm rotation. Surgical fixation is required for most displaced adult forearm fractures to restore anatomic alignment, allow early mobilization, and ensure optimal functional recovery. Dr. Kumar utilizes advanced fixation techniques including anatomically contoured locking compression plates (LCP), specialized radius and ulna plates designed to match bone curvature, minimally invasive plating techniques when appropriate, and intramedullary nailing for specific fracture patterns. Arthoscenter's dedicated trauma operating rooms are equipped with high-quality fluoroscopy and specialized fracture reduction instruments enabling precise restoration of forearm anatomy. Typical recovery involves 6-8 weeks for initial bone healing with progressive range of motion exercises, followed by 3-4 months for complete union and return to normal activities. Most patients regain 85-95% of normal forearm rotation and wrist motion with proper surgical technique and rehabilitation. Early complications like infection and nerve injury are rare (<3%), while hardware prominence requiring later removal occurs in approximately 10-15% of cases.

Symptoms & Indications

This surgery may be recommended if you experience:

Immediate severe pain in forearm after injury - pain intensifies with any attempt to move wrist or elbow

Visible deformity or abnormal angulation of forearm - obvious bend or shortening compared to other arm

Swelling and bruising throughout forearm - rapidly developing within 30-60 minutes of injury

Inability to rotate forearm (pronation/supination) - cannot turn palm up or down

Tenderness to touch along radius or ulna shaft - point tenderness at fracture site

Crepitus or grinding sensation when forearm is gently moved - bone ends rubbing together

Limitation of wrist and elbow motion - unable to flex or extend due to pain and instability

Open fracture with bone visible through skin wound - surgical emergency requiring immediate treatment

Numbness or tingling in hand - may indicate nerve injury especially median or radial nerve

Compartment syndrome symptoms - severe pain, tight swollen forearm, pain with passive finger extension

Procedure Details

Duration

Isolated radius or ulna fracture fixation: 60-90 minutes. Both-bone forearm fracture fixation: 90-150 minutes depending on fracture complexity, comminution, and whether open or closed injury. Severe comminuted fractures or fractures with soft tissue injury may require 2-3 hours. Revision surgery or delayed unions: 2-4 hours.

Anesthesia

General anesthesia with endotracheal intubation is standard for forearm fracture fixation providing airway protection, complete muscle relaxation facilitating fracture reduction, and patient comfort during typically 1.5-2.5 hour procedure. Regional anesthesia (interscalene or supraclavicular brachial plexus block) frequently added providing excellent postoperative pain control for first 12-18 hours and reducing opioid requirements. Some surgeons prefer regional anesthesia alone for cooperative patients and less complex fractures, though complete muscle relaxation often better achieved with general anesthesia. Axillary block alternative but may not provide adequate proximal coverage for very proximal radius fractures.

Preparation for Surgery

Comprehensive pre-operative planning critical for optimal forearm fracture fixation outcomes. Initial assessment includes detailed AP and lateral X-rays of entire forearm including wrist and elbow joints to evaluate fracture pattern, displacement, comminution, and any associated injuries. CT scan obtained for complex intra-articular fractures extending into wrist or elbow, severely comminuted fractures, or cases where fracture configuration unclear on plain films. Thorough neurovascular examination documenting median nerve (sensation over thumb/index/middle fingers, thenar muscle strength), radial nerve (wrist/finger extension, sensation over dorsal thumb), and ulnar nerve (sensation over ring/little fingers, intrinsic hand muscle strength) function essential before surgery. Vascular status assessed by checking radial and ulnar pulses, capillary refill, and hand perfusion. Compartment pressures measured if compartment syndrome suspected based on severe pain, tense forearm swelling, pain with passive finger extension. Patients kept NPO (nothing by mouth) for 6-8 hours prior to surgery. Pre-operative antibiotics (typically 2g Cefazolin IV or Ceftriaxone 1g IV) administered within 60 minutes before incision. Fracture reduction tables or radiolucent arm tables arranged. Specialized implants selected based on fracture pattern: 3.5mm LC-DC plates for radius, 3.5mm LC-DC or reconstruction plates for ulna, specific distal radius plates if fracture extends distally, intramedullary nails for appropriate patterns. High-quality fluoroscopy (C-arm) positioned for AP and lateral imaging of forearm.

Surgical Steps

Patient positioned supine on operating table with affected arm extended on radiolucent arm board at 90° to body

General anesthesia induced with endotracheal intubation; regional anesthesia (interscalene or supraclavicular block) may be added for postoperative pain control

Pneumatic tourniquet applied to upper arm (typically inflated to 250mmHg for adults) to minimize bleeding and improve visualization

Entire upper extremity from shoulder to fingertips prepared with chlorhexidine or povidone-iodine antiseptic solution

Sterile draping applied isolating arm from shoulder to hand, with stockinette over hand and fingers

Ulna typically addressed first (if both bones fractured) as it serves as stable reference for radius alignment

For ulna fixation: longitudinal incision centered over subcutaneous ulnar border (ulna easily palpable along entire length)

Incision length typically 8-12cm depending on fracture zone and comminution, centered over fracture site

Skin and subcutaneous tissue divided sharply; minimal subcutaneous dissection needed as ulna is subcutaneous

Periosteum incised longitudinally directly over fracture site and elevated minimally only at fracture zone

Fracture hematoma evacuated; fracture ends visualized ensuring no soft tissue interposition preventing reduction

Fracture reduced manually using combination of traction, direct manipulation, and reduction clamps

Reduction assessed using fluoroscopy in AP and lateral views confirming anatomic alignment without rotation

Appropriate ulna plate (typically 3.5mm narrow LC-DC plate or one-third tubular plate) selected and contoured to match ulnar bow

Plate positioned on dorsal or volar surface of ulna (surgeon preference; dorsal more common, easier access)

Plate provisionally fixed with reduction clamp; 2.5mm drill bit used to drill first screw hole

Initial screw (non-locking cortical screw) inserted engaging both cortices, tightened to compress fracture if transverse pattern

Additional screws placed proximally and distally (minimum 3 screws, ideally 6 cortices each side of fracture)

Final fluoroscopy confirming ulna plate position, fracture alignment, and appropriate screw length (bicortical engagement without excessive penetration)

Attention turned to radius (more technically demanding due to curvature and muscle coverage)

For radius exposure: volar (Henry) approach most common for middle/distal third fractures

Skin incision along radial border of forearm from biceps tendon proximally to wrist flexion crease distally (10-15cm)

Subcutaneous tissue divided; cephalic vein identified and preserved (ligated only if necessary for exposure)

Interval between brachioradialis (radial nerve innervated) and flexor carpi radialis (median nerve innervated) developed

For proximal third fractures, interval between brachioradialis and pronator teres used, protecting radial nerve

Superficial radial nerve identified crossing field obliquely and gently retracted laterally with brachioradialis

Pronator teres identified inserting on lateral radius mid-shaft; carefully elevated from radius if fracture in this zone

Flexor pollicis longus and flexor digitorum superficialis retracted medially protecting median nerve

Periosteum incised longitudinally over fracture site; minimal subperiosteal dissection preserving fracture hematoma and soft tissue attachments

Fracture reduced restoring radial bow and rotational alignment (proximal fragment supinated by biceps, distal pronated)

Reduction maintained with pointed reduction forceps or K-wires used as joysticks in fracture fragments

Pre-contoured radius plate (following natural radial bow) positioned on volar surface spanning fracture

Plate secured with locking or non-locking 3.5mm screws, minimum 3 screws (6 cortices) each side of fracture

Intraoperative fluoroscopy confirming radius fracture reduction, plate position, and that screws do not violate proximal radioulnar or distal radioulnar joints

For both-bone fractures: final fluoroscopy in full pronation and supination confirming maintained reduction throughout arc of motion

Passive pronation-supination tested confirming smooth motion without crepitus or restriction (should achieve near-full range)

All wounds irrigated copiously with 3-6 liters normal saline to minimize infection risk

Hemostasis achieved with electrocautery; tourniquet deflated and any bleeding vessels cauterized

Layered wound closure: periosteum not routinely closed; muscle layers approximated with 2-0 or 3-0 absorbable sutures

Subcutaneous layer closed with 3-0 absorbable sutures; skin closed with 3-0 or 4-0 nylon or staples

Sterile dressings applied; well-padded posterior splint fabricated maintaining forearm in neutral rotation (thumb pointing up)

Post-operative X-rays obtained in recovery room (AP and lateral forearm) confirming hardware position and alignment

Patient monitored for compartment syndrome symptoms; neurovascular checks every 1-2 hours first 24 hours

If open fracture: wounds left open or loosely approximated; planned return to OR in 48-72 hours for delayed closure after infection risk reduced

Recovery Timeline

What to expect during your recovery journey

Week 1-2: Immediate Post-Operative

Wound Healing and Early Mobilization

Patient hospitalized 1-2 days post-surgery for pain management and neurovascular monitoring. Posterior splint maintained keeping forearm in neutral rotation for comfort and protection. Elevation of arm above heart level essential first 48-72 hours to minimize swelling (use pillows, sling when upright). Finger, elbow, and shoulder active range of motion exercises started immediately to prevent stiffness - patient should make full fist and fully extend fingers 10 times every waking hour. Ice application 15-20 minutes every 2-3 hours to reduce swelling and pain. Wound checks at 2-3 days and 7-10 days; sutures/staples removed at 10-14 days. Pain typically moderate, managed with oral analgesics (acetaminophen, NSAIDs if no contraindications, short course opioids if needed). X-rays obtained at first follow-up (10-14 days) to confirm maintained alignment. No lifting, pushing, or pulling with affected arm. Splint removed temporarily for wound care and hygiene but reapplied for protection. Neurovascular checks at each visit ensuring no nerve injury or compartment syndrome.

Week 2-6: Fracture Healing Phase

Progressive ROM Without Resistance

Splint discontinued at 2-3 weeks once soft tissue healing adequate; transition to removable wrist brace for comfort only (not structural support - plates provide stability). Formal physical therapy initiated focusing on gentle active range of motion exercises for wrist flexion/extension, forearm pronation/supination (turning palm up/down), and elbow flexion/extension. Passive stretching avoided until 6 weeks to protect healing fracture. X-rays every 2-4 weeks monitoring fracture healing and confirming no loss of reduction. Callus formation typically visible on X-rays by 4-6 weeks indicating bone healing progressing. Light activities of daily living permitted with affected arm (eating, writing, computer use) but no heavy lifting. Driving typically permitted at 4-6 weeks if patient can safely control vehicle and is off narcotic pain medications. Return to office/desk work possible at 2-4 weeks depending on arm dominance and job requirements. Persistent swelling common; continued elevation and compression sleeve may help. Pain should be progressively decreasing; if pain increases or becomes severe, immediate evaluation needed to rule out complications.

Week 6-12: Strengthening Phase

Progressive Resistance and Functional Activities

X-rays at 6-8 weeks should show bridging callus across fracture site indicating sufficient healing to begin strengthening. Physical therapy advanced to include resistance exercises starting with 0.5-1kg weights for wrist curls, pronation/supination strengthening, and grip strengthening. Gradual progression of weight/resistance every 1-2 weeks as tolerated without pain. Return to light manual labor and overhead activities typically permitted at 8-10 weeks. Sports involving upper extremity use (swimming, cycling, golf) may begin at 10-12 weeks with therapist and surgeon approval. Most patients regain 80-90% of forearm rotation and wrist motion by 12 weeks. Bone healing typically complete by 10-14 weeks with solid bridging callus on all cortices visible on X-rays. Persistent stiffness addressed with aggressive physical therapy; if plateau in range of motion despite therapy, formal manipulation under anesthesia rarely considered. Hardware prominence or irritation may become apparent; if symptomatic, hardware removal planned after fracture fully healed (minimum 12-18 months).

Month 3-6: Return to Full Activities

Advanced Strengthening and Sports-Specific Training

Fracture should be solidly healed by 3-4 months; X-rays showing complete cortical bridging and remodeling. Progressive return to all normal activities including contact sports, heavy manual labor, and high-demand recreational activities. Advanced strengthening focusing on sport-specific or job-specific movements and building endurance. Most patients achieve 85-95% of normal strength and 90-95% of motion compared to uninjured arm by 6 months. Residual stiffness in pronation/supination most common long-term issue; aggressive therapy may continue if functional deficits persist. Hardware removal discussion if patient experiencing hardware irritation, prominence causing discomfort, or preference to have hardware removed - typically performed as outpatient procedure at 12-18 months post-fixation. Final X-rays at 6 months; if healing complete and patient asymptomatic, further routine radiographs not necessary unless problems develop. Return to full unrestricted activities including contact sports, heavy lifting, and manual labor typically cleared at 4-6 months post-surgery.

Month 6-12: Long-Term Follow-Up

Monitoring for Late Complications

Most patients fully recovered by 6-12 months with 90-95% return of function compared to uninjured side. Small percentage of patients experience persistent stiffness, particularly limited pronation-supination, which may be permanent if therapy does not improve it. Hardware removal considered if symptomatic prominence, irritation with activities, or patient preference - performed as outpatient surgery once fracture solidly healed. Late complications monitored including nonunion (failure to heal - very rare with proper surgical technique, occurs in <2% cases), malunion (healed in wrong position causing functional limitation or cosmetic deformity), and post-traumatic arthritis of wrist or elbow if fracture extended into joint. Annual follow-up X-rays not routinely needed if patient asymptomatic and fracture healed on prior films. Patients counseled that full recovery including bone remodeling and maximal strength return may take 12-18 months. If planning hardware removal, typically performed between 12-24 months post-fixation once bone fully consolidated and remodeled.

Tips for Faster Recovery

ELEVATION IS CRITICAL - keep arm elevated above heart level using pillows for first week, significantly reduces swelling and pain

Finger exercises ESSENTIAL - make full fist and fully extend fingers 10 times every hour while awake to prevent stiffness

DO NOT neglect elbow and shoulder - move these joints through full range daily to prevent frozen shoulder or elbow stiffness

Wound care: keep incisions clean and dry until sutures removed; after removal, gentle washing with soap and water acceptable

Watch for infection signs: increasing redness, warmth, drainage, fever >101°F - requires immediate medical attention

COMPARTMENT SYNDROME warning signs first 48 hours: severe pain not relieved by medications, tight swollen forearm, numbness/tingling in hand, pain with passive finger straightening - EMERGENCY requiring immediate return to hospital

Remove splint only as instructed by surgeon; premature discontinuation risks losing fracture reduction despite plate fixation

Nerve symptoms (numbness, tingling, weakness) should improve progressively; worsening nerve symptoms require urgent evaluation

Physical therapy compliance directly correlates with outcome - attend all sessions and perform home exercises daily

Resistance exercises should NOT cause significant pain; mild discomfort acceptable but severe pain indicates overdoing it

Forearm rotation (pronation/supination) most challenging motion to regain - focus extra attention on these exercises

DO NOT attempt heavy lifting until cleared by surgeon (typically 10-12 weeks minimum) - risks hardware failure or refracture

Smoking cessation ESSENTIAL - smoking significantly impairs bone healing and increases risk of nonunion

Nutrition important for bone healing: ensure adequate protein (1.2-1.5g/kg body weight daily), calcium (1200mg daily), vitamin D (2000 IU daily)

Hardware removal optional if asymptomatic; if hardware prominent and bothersome, removal possible after 12-18 months once bone healed

Frequently Asked Questions

Common questions about this procedure

Q1.Do all forearm fractures require surgery, or can some be treated with casting?

Treatment decision depends on fracture displacement, location, patient age, and functional demands. In CHILDREN, most forearm fractures can be treated with closed reduction and casting because children have excellent bone remodeling capacity - even angulated fractures up to 20-30° in young children will remodel completely with growth. Pediatric forearm fractures treated with long-arm casting for 6-8 weeks typically heal well. However, ADULT forearm fractures have much stricter surgical indications because adults do not remodel malunited fractures and even small degrees of angulation or rotation cause significant functional impairment. Surgery recommended for adults if: (1) Both radius and ulna fractured (both-bone fractures) - virtually always require surgery as maintaining alignment in cast extremely difficult and malunion very common with casting alone, (2) Displacement >50% bone width or angulation >10-15°, (3) Shortening >5mm, (4) Intra-articular fractures extending into wrist or elbow joints, (5) Open fractures, (6) Fractures associated with neurovascular injury, (7) Galeazzi fractures (radius fracture with distal radioulnar joint disruption) - always require surgery, or (8) Monteggia fractures (ulna fracture with radial head dislocation) - always require surgery. Non-displaced or minimally displaced isolated ulna or radius fractures in low-demand elderly patients may be candidates for casting, but requires close follow-up with weekly X-rays for 3 weeks to ensure no loss of reduction. Success rate of non-operative treatment for adult displaced forearm fractures very poor (<40% good outcomes) compared to surgical fixation (>90% good-excellent outcomes), which is why surgery standard of care for most adult forearm fractures.

Q2.What are the risks of forearm fracture surgery and how common are complications?

Forearm fracture fixation generally safe procedure with low complication rates in experienced hands, but potential risks include: INFECTION (surgical site infection 2-4% overall, higher 15-20% for open fractures despite antibiotics; superficial wound infection treated with oral antibiotics, deep infection involving bone or hardware requires return to OR for irrigation/debridement and IV antibiotics 4-6 weeks), NERVE INJURY (radial nerve 2-3% especially with radius fractures, presents as wrist/finger drop and numbness over dorsal thumb; median nerve 1-2% particularly with volar approach to radius; ulnar nerve <1%; most nerve injuries are traction neuropraxias that recover spontaneously over 3-6 months, but permanent injury possible), COMPARTMENT SYNDROME (acute compartment syndrome 1-3% especially with high-energy trauma or both-bone fractures; emergency requiring urgent fasciotomy within 6-8 hours to prevent muscle death and contracture; warning signs include severe pain, tense forearm, pain with passive finger extension), NONUNION (failure of fracture to heal, occurs in <2% forearm fractures with proper surgical technique; risk factors include smoking, diabetes, NSAIDs use, infection, inadequate fixation; requires revision surgery with bone grafting), MALUNION (healing in incorrect position causing functional limitation; rotation malunion particularly problematic limiting pronation-supination; may require corrective osteotomy if causing significant disability), HARDWARE PROMINENCE (10-15% patients experience hardware irritation especially over subcutaneous ulna; may require hardware removal once fracture healed), REFRACTURE (occurs in <2% after hardware removal; risk highest in first 6 months after plate removal; temporary bracing after removal may reduce risk), STIFFNESS (some loss of pronation-supination common, most patients achieve 85-95% of opposite side; wrist and elbow stiffness less common with early mobilization), HETEROTOPIC OSSIFICATION (abnormal bone formation in soft tissues, rare <1%, more common after high-energy trauma), and RADIOULNAR SYNOSTOSIS (bony bridge forming between radius and ulna completely eliminating forearm rotation; rare complication <1% but devastating functionally; more common when both bones fractured at same level or with extensive soft tissue trauma; may require surgical excision). Despite these risks, overall complication rate relatively low (10-15% any complication, <5% major complication requiring revision surgery), and functional outcomes generally excellent with >90% patients returning to normal activities.

Q3.How long does it take to regain full forearm rotation after both-bone forearm fracture surgery?

Forearm rotation (pronation-supination) recovery most challenging aspect of rehabilitation after both-bone forearm fracture fixation. Timeline varies based on fracture severity, soft tissue injury, surgical technique, and rehabilitation compliance. TYPICAL RECOVERY TIMELINE: Week 0-2 (no rotation attempted, forearm immobilized in neutral position for comfort and soft tissue healing), Week 2-6 (gentle active pronation-supination exercises started at 2-3 weeks once splint discontinued; most patients achieve 30-50% of normal rotation by 6 weeks; passive stretching avoided to protect healing fracture), Week 6-12 (progressive improvement with therapy; most patients achieve 60-80% rotation by 12 weeks as fracture solidly healing and aggressive therapy instituted), Month 3-6 (continued improvement with most patients achieving 80-90% of opposite side rotation by 6 months; plateau in recovery typically occurs around 4-6 months), Month 6-12+ (gradual improvement may continue up to 12 months but most recovery achieved by 6 months). EXPECTED OUTCOMES: Most patients (75-85%) regain 85-95% of normal forearm rotation compared to uninjured arm, which is functionally excellent for daily activities. About 10-15% patients experience more significant limitation (60-80% of normal) which may cause functional issues with specific activities requiring extreme pronation/supination (turning screwdriver, opening jars, etc.). Only 2-5% patients have severe limitation (<60% rotation) indicating complication like malunion, synostosis, or severe soft tissue scarring. FACTORS AFFECTING ROTATION RECOVERY: (1) Fracture location - middle third both-bone fractures highest risk of stiffness; isolated radius or ulna fractures typically better motion, (2) Restoration of radial bow - critical to maintain natural radius curvature during surgery, (3) Soft tissue injury severity - high-energy trauma with muscle damage causes more scarring and stiffness, (4) Rehabilitation compliance - aggressive early motion and therapy critical for optimal rotation recovery, (5) Complication occurrence - infection, compartment syndrome, or heterotopic ossification significantly impair motion. If rotation plateaus at unsatisfactory level (<70% of normal) despite 6+ months aggressive therapy, options include hardware removal if prominent (may improve 10-15° additional rotation), capsular release surgery (rarely indicated), or acceptance and activity modification.

Q4.When can I return to work, driving, and sports after forearm fracture surgery?

Return to activities timeline depends on fracture healing, job/sport demands, and whether injury to dominant or non-dominant arm. OFFICE/DESK WORK: Light desk work possible at 2-4 weeks if non-dominant arm injured or job requires minimal arm use. If dominant arm injured and job requires extensive computer/writing, may need 4-6 weeks until can use arm comfortably. DRIVING: Most patients resume driving at 4-6 weeks once: (1) off narcotic pain medications (legally cannot drive while taking opioids), (2) can safely grip steering wheel and control vehicle, (3) can react quickly in emergency (depends on right vs left arm injury and manual vs automatic transmission). Some patients with non-dominant arm injury in automatic vehicle may drive earlier (2-3 weeks) with surgeon approval, but must ensure can safely control vehicle. MANUAL LABOR: Light manual labor (lifting <10lbs, no heavy pushing/pulling) possible at 6-8 weeks. Moderate manual labor (lifting 10-25lbs) typically 10-12 weeks. Heavy manual labor (lifting >25lbs, construction work, etc.) requires 3-4 months until fracture solidly healed and strength recovered. Some very heavy occupations may require 4-6 months for full duty. SPORTS: Non-contact sports not involving upper extremity (running, cycling, swimming with pull buoy) possible at 4-6 weeks. Sports using arms without contact (golf, swimming, tennis) typically 10-14 weeks with gradual return. Contact sports or sports with falling risk (football, basketball, martial arts, skiing) require 4-6 months until fracture fully healed and protective plate removed or patient counseled about refracture risk if plates retained. Elite athletes may attempt accelerated return at 3-4 months with protective bracing, accepting some risk. GENERAL GUIDELINES: Can use arm for light activities (eating, dressing, light household tasks) within 2-3 weeks. Progressively increase use as tolerated without significant pain. Avoid heavy lifting, pushing, pulling, or impact activities until cleared by surgeon (typically 3-4 months minimum). Listen to your body - activities causing significant pain indicate overdoing it and should be scaled back. Most patients (>90%) return to all pre-injury activities by 4-6 months post-surgery.

Q5.What is the cost of radius and ulna fracture surgery and is it covered by insurance?

Cost of forearm fracture fixation varies based on fracture complexity (isolated vs both bones), surgery duration, implants used, hospital stay, and whether open or closed fracture. AT ARTHOSCENTER PATNA, typical costs include: ISOLATED RADIUS OR ULNA FRACTURE FIXATION: ₹80,000-₹1,40,000 covering surgeon fees, anesthesia, single bone plating with standard 3.5mm LC-DC plate (6-8 screws), 1-2 day hospitalization, and post-operative care including 3-4 follow-up visits with X-rays. BOTH-BONE FOREARM FRACTURE FIXATION: ₹1,40,000-₹2,20,000 covering surgeon fees, anesthesia, two-bone plating (radius and ulna plates, typically 12-16 total screws), longer operative time, 1-2 day hospitalization, and post-operative care. Cost higher end if anatomically pre-contoured implants used or locking plates required. COMPLEX/COMMINUTED/OPEN FRACTURES: ₹2,00,000-₹3,50,000 for severely comminuted fractures requiring multiple plates, bone grafting, external fixation, or open fractures requiring extensive soft tissue management, longer hospitalization, multiple surgeries, and IV antibiotics. ADDITIONAL COSTS: Physical therapy ₹500-₹1,000 per session (typically 12-20 sessions needed = ₹6,000-₹20,000 total), post-operative medications ₹2,000-₹5,000, and if hardware removal desired later ₹50,000-₹80,000 (outpatient surgery). INSURANCE COVERAGE: Forearm fracture surgery considered MEDICALLY NECESSARY trauma care and typically WELL COVERED by most Indian health insurance policies with cashless facility available at Arthoscenter for major insurers (Star Health, ICICI Lombard, HDFC Ergo, Care Health, etc.). Patient co-pay typically 10-20% of total cost depending on policy. Government schemes (PMJAY/Ayushman Bharat) provide coverage for eligible patients with minimal out-of-pocket cost. PAYMENT OPTIONS: Cash discounts (5-10%), EMI plans available, partnered with healthcare financing companies for 0% interest payment plans up to 12 months. Dr. Kumar believes cost should not prevent patients from receiving proper surgical care for displaced forearm fractures, as attempting non-operative treatment for fractures requiring surgery often results in malunion, permanent functional limitation, and ultimately higher costs from failed treatment and potential revision surgery.

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