Radioulnar transposition. Salvaging a shattered forearm

1. A forearm shattered by a close-range shotgun injury can be reconstructed by transposing the distal radius to the proximal ulna. 2. This surgery is considered when repair of the bones is impossible, but an effort at reconstruction is warranted as an alternative to amputation. 3. A successful forearm reconstruction not only saves the forearm, wrist, and hand, but restores a satisfactory cosmetic and functional result. 4. Because radioulnar transposition re-establishes the bony integrity, future reconstruction in the form of tendon transfers may be undertaken to improve hand and wrist function.