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1Principles

Principles

Which bone should be addressed first?

This issue is controversial. On one hand, the preference could be to start with the radius with its more complex shape, or with the more comminuted fracture pattern, in order to facilitate the manipulation of the forearm. Nailing the other bone first might limit this possibility.
On the other hand, starting with the easier fracture, or the more simply shaped ulna, may assist in restoring length and alignment of the forearm.
In certain circumstances, depending on soft-tissue compromise and fracture morphology, nailing of one bone and plating of the other bone is an option.