Cross-union complicating fracture of the forearm. Part II: Children

Cross-union is a rare complication of fractures of the forearm in children. Of the ten cross-unions reported in this series, four were Type 2 (middle third or non-articular part of the distal third of the radius and ulna) and six were Type 3 (proximal third of the forearm). There were no Type-1 (intra-articular part of the distal third of the radius and ulna) cross-unions. As in adults, the Type-2 cross-unions followed a high-energy injury. Three of the four Type-2 cross-unions were excised; one of them recurred. Type-3 cross-unions occurred equally after closed or open reduction of a fracture. Three patients with a Type-3 cross-union had excision of the radial head. The only patient who did not have a recurrence of the cross-union also underwent insertion of a prosthesis for the radial head. The results after resection of a cross-union appear to be better in the adult than in the child, although the number of patients in this and other studies is too small to allow firm conclusions.