Executive Editor: James Hunter

General Editor: Fergal Monsell

Authors: Andrew Howard, Peter Schmittenbecher, Theddy Slongo

Pediatric forearm shaft 22u-D/1.1

General considerations

The choice of treatment is determined by the functional effect of residual deformity on forearm pronation and supination.

Restriction of function is more important than the degree of deformity.

If the function is nearly normal, immobilization with a cast or splint is sufficient to manage pain.

If the initial function is significantly limited, it is important to differentiate between the relative contribution of pain and deformity.

In this situation it is recommended to re-evaluate 3-4 days after immobilization and change treatment if necessary.

Note: Bowing may recur by elastic recoil even after complete initial correction.

Note: Isolated ulnar fractures may be associated with proximal radio-ulnar joint subluxation/dislocation (Monteggia lesion).

Initial x-rays must be carefully evaluated to identify fractures of the radial head or neck.

Stability of the joint must be confirmed in every case, using an image intensifier if necessary.

Appendix

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Decision support

Authors' added material

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v1.0 2018-11-28