Radius and Ulnar Shaft Fractures

Forearm shaft fractures can be a result of high- and low-energy trauma. Although the diagnosis of these lesions is usually straightforward, a complete upper extremity examination should be performed to avoid missing associated injuries. In those rare cases where truly stable undisplaced isolated bone fractures occur, nonoperative treatment may be indicated. Otherwise, a policy of zero tolerance toward displacement should be adopted. Either 3.5 LC-DCP plates or anatomical plates should be used and a minimum of six cortices in each main fragment is required. When third wedge fractures are present, a 2.7 mm or even 2.4 mm lag screw is recommended. In simple transverse patterns, slightly prebend the plate to avoid fracture gap on the opposite cortex to the plate. Both-bone fractures should be addressed by two separate incisions. A stable construct is paramount prompt motion as soon as tolerated which leads to the best outcome.