Executive Editor: James Hunter

General Editor: Fergal Monsell

Authors: Andrew Howard, Peter Schmittenbecher, Theddy Slongo

Pediatric forearm shaft p22-D/9

Overview

Safe zones for pins (ulna) i

The forearm anatomy is complex due to the presence of three major neurovascular bundles. Pin placement should avoid these structures.

ESIN entry points (radius) i

In the distal radius use either the lateral or Lister’s tubercle entry point.

ESIN entry points (ulna) i

In the ulna use either the proximal lateral or the distal medial entry point.

Approach to the ulna i

The standard ulnar approach offers good exposure along the whole ulnar shaft. The length of the incision depends on the exposure needed.

Lateral approach (elbow) i

The lateral (Kocher) approach can be used to access the radial head and the tip of the coronoid.

In pediatrics the most common use of this approach is open reduction of radial head/neck fractures.

Posterolateral approach (elbow) i

In proximal ulnar injuries associated with radial head dislocation or radial neck fractures, both bones can be addressed through a lateral extension of the posterior skin incision (Boyd).

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v1.0 2018-11-28