Pediatric Fractures of the Hand, Wrist, Forearm, and Elbow-Case: Both Bone Forearm Fractures

Case: Both Bone Forearm Fractures

Pdf Summary

A 12-year-old girl has suffered a mid-shaft both bone forearm fracture due to a fall. Multiple treatment options are available, including ORIF (open reduction and internal fixation) with plate/screw construct, flexible nailing of both bones, single bone fixation, or a combination of techniques. In this case, ORIF was chosen, starting with the ulna to address the fracture there and potentially prevent the need for fixation in the radius. However, the radius still required surgical attention after ulnar fixation.<br /><br />Key points about both bone forearm fractures include their common occurrence in children, acceptable angulation and malrotation depending on the patient's age and location of the fracture, and the need for near anatomic alignment in older patients and proximal diaphyseal fractures.<br /><br />Complications of treatment can include loss of fixation, neuropraxia, compartment syndrome (most commonly caused by too many attempts at passage of an intramedullary device), and hardware issues, such as a prominent rod.<br /><br />Nonsurgical treatment options involve closed reduction and casting, with close follow-up for the first two weeks. The palm is immobilized in a neutral or directed position toward the fracture apex, and a good cast index is crucial. Surgical indications include open injuries and forearm fractures that do not fall within acceptable tolerances for nonsurgical treatment.

Keywords

forearm fracture

ORIF

treatment options

ulna fixation

radius fixation

both bone fractures

complications

nonsurgical treatment

closed reduction

casting