Forearm fractures - distal third

Case contributed by Leonardo Lustosa
Diagnosis certain


Fall from a bike. Obvious forearm deformity upon physical examination.

Patient Data

Age: 9 years
Gender: Male

Radiographs revealed a distal third both-bone forearm fracture, with a complete fracture of the radius and a greenstick fracture of the ulna.

Both fractures are angulated nearly 30º. There is minimal displacement of the radial fracture.

Case Discussion

Forearm fractures are the most common long bone fractures in children.

These fractures usually fare well with non-operative treatment. In the present case, however, if better reduction and correction of angulation is not achieved by closed reduction and immobilization, operative treatment must be considered.

Acceptable residual angulation after closed reduction is still a topic of debate amongst orthopedic surgeons. Most literature considers an acceptable angulation of distal third fractures to be <20º. Furthermore, up to 100% of translation can be accepted, and a shortening <1 cm.

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