Pediatric fractures: fracture both bone forearm
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AP View of forearm of child
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lateral view of forearm of child
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This is the case of an 8 yr old
boy with history of fall from jamun tree. He had severe pain in left forearm
with swelling and abnormal mobility. Xrays showed fracture both bone left
forearm with comminution and impaction of radius. A sincere attempt at closed
reduction under anesthesia was made. However, the reduction though achieved,
was not held satisfactorily in plaster. Since the parents were counseled and
preparations were already done, in same anesthesia sitting, the child was
operated and plating was done. A distal end radius plate was used to fix
radius. The one third tubular plate used to fix ulna had only two screws in
distal fragment. The most important thing to keep in mind while operating a
pediatric fracture is to respect the physis. The implant must not include-span
the physis. Any accidental injury to the physis must be avoided. If the physis
must be crossed, then the wires with smallest diameter must be used and all
such hardware must be removed as early as possible. However, if the identity of
the fracture demands, 1/3rd of the physis can be pierced without
significant growth disturbances.