Forearm Fracture Failed Fixation

Abstract

Both bone forearm fractures in skeletally mature individuals are injuries commonly treated successfully with plate fixation (Anderson et al., J Bone Joint Surg Am 57:287–97, 1975; Chapman et al., J Bone Joint Surg Am 71:159–69, 1989; Schulte et al., J Am Acad Orthop Surg 22:437–46, 2014; Droll et al., J Bone Joint Surg Am 89:2619–24, 2007; Leung and Chow, J Orthop Surg (Hong Kong) 14:291–4, 2006). Loss of alignment can cause notable dysfunction given the importance the radial and ulnar shaft have on forearm rotation. Correction, with or without osteotomy, is recommended when malalignment is present (Schemitsch and Richards, J Bone Joint Surg Am 74:1068–78, 1992; Chia et al., J Hand Surg Eur Vol 36:102–6, 2011; Jayakumar and Jupiter, Hand (N Y) 9:265–73, 2014). This case presents a 23-year-old male who underwent surgical fixation of a closed both bone forearm fracture 1 month prior to presentation. The patient presented with pain and deformity in the forearm; radiographs showed angulation and malalignment of the radius and ulna through the implanted plates. The patient was taken to the operating room for removal of implants, realignment of the radius and ulna, and application of rigid revision fixation and uncomplicated union. The case highlights the importance of fixation strategies, including implant selection, in the forearm to allow for healing and early range of motion.