Midshaft radius and ulnar fractures

Case contributed by Andrew Baker
Diagnosis certain

Presentation

The patient presented with significant pain and obvious deformity following a trampoline accident. A median nerve palsy was found on examination.

Patient Data

Age: 8-16 years
Gender: Female

Midshaft fractures of the radius and ulna.

Fluoroscopy

Titanium Elastic Nails used to achieve and maintain suitable reduction. 

Case Discussion

​The degree of angulation in forearm fractures is a key determinant for management. In this case, the angulation was greater than acceptable, and could not be maintained in an adequate position following closed reduction. Hence, ORIF with Titanium Elastic Nails was used to achieve a satisfactory result.

For a midshaft forearm fracture in the pediatric population, acceptable angulation is:

  • <10 years: <15o (<20o is acceptable in <5 year olds)
  • >10 years: <10o

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