Midshaft Both Bone Forearm Fracture: Intramedullary Rod Fixation

Abstract

A 10-year-old right-hand dominant male sustained closed diaphyseal fractures of his radius and ulna. He underwent attempted closed reduction and casting of his fractures in the Emergency Department under conscious sedation. The fracture pattern was found to be unstable and therefore he underwent open reduction and intramedullary fixation of his radius and ulna in the operating room. Intramedullary fixation can be performed with small incisions and minimal soft tissue disruption, even when open reduction is required. Based on his age and fracture pattern, his fractures were felt to be appropriate for intramedullary fixation. The radius fracture required open reduction in order to achieve acceptable alignment as periosteum remained interposed at the fracture site. Both the radius and ulna were stabilized with elastic nails. After stabilization, patients require a period of cast immobilization. Most patients elect to have hardware removal after the fracture is united. This patient achieved union of his radius and ulna fractures with uneventful hardware removal at approximately 6 months after his initial surgery.