Paediatric Fractures Midshaft Radius & Ulnar

Types

  • Plastic deformation
  • Greenstick
  • Displaced

Radius & Ulna Shaft Fractures in 4 year old

Radius & Ulna Shaft Fractures in 4 year old

Acceptable Reduction

  • < 8 – midsaft 15-20° of angulation
  • >8  – midshaft 10° of angulation
  • avoid shortening

Treatment

Closed Reduction & POP

  • Reduction
    • apex volar = pronate
    • apex dorsal =supinate
  • Local muscle actions must be accounted for
  • Prime deforming force
    • proximal = supinator
    • distal = pronation
  • POP
    • flat
    • molded into an oval
    • above elbow

Radius & Ulna Shaft Fractures in 4 year old treated with Flexible IM Nailing

Radius & Ulna Shaft Fractures in 4 year old treated with Flexible IM Nailing

Indications for Surgery

  • Absolute
    • Open fracture
    • Inadequate reduction
    • Failure of closed treatment
  • Relative
    • refracture to prevent losses of ROM in older kid