Executive Editor: James Hunter

General Editor: Fergal Monsell

Authors: Andrew Howard, Peter Schmittenbecher, Theddy Slongo

Pediatric forearm shaft 22u-D/4.2

General considerations

These fractures are unstable and require anatomic reduction and stable fixation. Conservative treatment is not recommended as it may be very difficult to achieve stability.

Sufficient functional stability can be obtained with the following treatment options:

  1. ESIN: treatment of choice
  2. External fixator: for very unstable and comminuted fractures
  3. Plate osteosynthesis: in young adults (closed physis) or need for more stability during healing
  4. Closed reduction and cast fixation: no other option available, but unreliable

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.

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v1.0 2018-11-28