Single-bone fixation of both-bone forearm fractures

Area of Science:

• Pediatric Orthopedics
• Pediatric Trauma Surgery
• Pediatric Bone Fracture Management

Background:

• Diaphyseal both-bone forearm fractures in children often require surgical intervention when closed reduction fails.
• Traditional surgical fixation may involve plating both bones, which can be complex in pediatric patients.
• Alternative fixation strategies are needed to optimize outcomes and minimize complications.

Purpose of the Study:

• To evaluate the efficacy of treating pediatric diaphyseal both-bone forearm fractures by stabilizing only the radius or ulna.
• To assess the functional outcomes and complication rates associated with this single-bone fixation technique.

Main Methods:

• A retrospective review of seventeen children with diaphyseal both-bone forearm fractures was conducted.
• Sixteen patients, whose closed reduction had failed, underwent fixation of either the radius or ulna.
• Follow-up was until the clinical endpoint, assessing range of motion and union.

Main Results:

• Excellent clinical results were achieved in all sixteen followed patients.
• Full return of motion was observed in all but two patients, who had a minor loss of pronation (5 degrees).
• This is the first reported series exclusively examining single-bone fixation for pediatric diaphyseal both-bone forearm fractures.

Conclusions:

• Fixation of a single bone (radius or ulna) is an effective and safe treatment for pediatric diaphyseal both-bone forearm fractures where closed reduction has failed.
• This approach simplifies the procedure, avoids repeated anesthesia, and prevents malreduction without necessitating adult-style plating.
• Intramedullary fixation is preferred due to ease and safety of hardware placement and removal.