Midshaft Both Bone Forearm Fracture: Single Bone Fixation

Abstract

Both bone forearm fractures are common injuries in children. While some can be treated with closed reduction and casting, more unstable fractures may require operative treatment utilizing internal fixation. The amount of radius and ulna deformity that can be tolerated in the sagittal and coronal planes diminishes with age. Rotational deformity can never be accepted. Closed reduction and flexible intramedullary nailing of both bones has been a long-accepted treatment method in such injuries. Here we will discuss closed reduction and single bone fixation in the setting of both bone forearm fractures. In many cases, fixation of a single bone provides adequate stability when an acceptable reduction of both bones can be obtained. Instrumentation of only a single bone may decrease operative time and the amount of fluoroscopy used. Given the relative ease of instrumentation of the ulna, it is our preference to fix the ulna and rely on a well-molded cast to attain and maintain the radial bow. Postoperative management does not differ from fixation of both bones and relies on an appropriately molded cast and close follow up.