Proximal forearm Fracture Discussion
Proximal forearm fractures are associated with a variety of problems,
including nonunion, nerve and tendon injuries and synostosis. One fifth to
one half of patients can be expected to have significant permanent loss of
forearm rotation. Open treatment of acute fracture or nonunion may be
complicated by additional nerve injury or synostosis, more likely when
injuries are open or classified as high energy. Synostosis, or cross-union
between the radius and ulna is much more common in proximal than in distal
forearm fractures, occurring in about one out of fifteen patients with
proximal fractures. Synostosis is more likely in children, with open
fractures, with single incision access to both forearm bones, and following
high energy injuries. Results of surgery for correction of synostosis are
poor when surgery is performed less than one year or more than three years
after injury, and even under ideal conditions, only one in five patients
can be expected to regain as much as 50 degrees of forearm rotation.
Discussion Home Page