Bone Forearm Fractures Research Articles

Ефективність впливу засобів фізичної терапії на показники неврологічного та функціонального статусу китиці осіб з компресійною нейропатією серединного нерва як постіммобілізаційного ускладнення переломів дистальних відділів кісток передпліччя

The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

Лечение пациента с открытым переломом костей предплечья и обширным дефектом костной ткани (случай из практики)

Introduction Repair of a double open comminuted fracture of forearm bones with extensive bony loss is challenging due to a high risk of infection and the need to address a significant bony defect. Neither internal fixation nor open reduction could be considered due to substantial bone loss and severely impaired circulation with a high risk of soft tissue necrosis and infection. We report staged management of forearm fracture using avascular autologous graft to repair the defect and maintain the forearm length. Objective Demonstrate the successful management of the double open comminuted fracture of forearm bones with extensive bony loss using Ilizarov external fixation, classical autologous grafting harvested from fibula and intramedullary (IM) nailing. Results and discussion The limb was temporarily fixed with Ilizarov frame in an extra-focal manner. An autogenous fibular graft of 11 cm was used to fill in the gap. Intramedullary nailing of the radius and ulna was produced and ulnar defect was repaired with autogenous fibular graft. IM nails were removed once the bones consolidated. The limb function was completely regained, anatomical length of the segment maintained and metal constructs removed. Conclusion Combination of different bone fixation modalities, classical autografting technique and intramedullary nailing provided complete recovery of the broken limb maintaining the function and bringing down the risk of complications to ensure a good clinical result.

Analysis of functional outcome of both bone forearm fracture in paediatric age group managed conservatively during the SARS-CoV-2 Pandemic

Aims and Objectives: To study the functional outcome of closed reduction casting in both bone forearm fracture in paediatric age group. To evaluate the functional outcome of closed reduction casting in both bone forearm fractures in paediatric age group with the help of Price et al. criteria.Materials and Methods: A retrospective observational study was performed on patients treated in MGM Medical College and Hospital, Navi Mumbai from April 2020 to November 2020. A total of 30 cases of both bone forearm fractures in paediatric age group were treated with closed reduction casting. Their functional outcome post casting was evaluated according to Price et al. scoring.Results: Based on Price et al., criteria functional outcome was calculated which showed excellent results in 24 patients (80%), good in 4(13.33%), fair in 2(6.6%) and no poor results. All patients with excellent results had lost 10 degrees or less of forearm rotation. In four patients with good results, two had lost 11-30 degrees of forearm rotation while the other two had lost 10 degrees or less but grouped under good rather than excellent outcome since patients had mild complaints of pain and fatigue with strenuous activities.Conclusion: Non-operative treatment of both-bone diaphysis forearm fracture with closed reduction casting, has well to excellent functional outcomes in children in the age group of 4- 15 years.

A prospective study of surgical management of diaphyseal shaft fracture of bones of forearm in adults with limited contact dynamic compression plate

Fracture of forearm bone are one of the most common injuries seen in day to day practice. The forearm, in combination with the proximal and distal radioulnar joints, allows pronation and supination movements that are important in the usual activities of daily living. The forearm serves an important role in upper extremity function. Decisive management is required after fractures of the shafts of the radius and ulna if function is to be restored. The Limited Contact Dynamic Compression Plate, was developed by Perren S. M. et to release the new concept of biological internal fixation. Grooves on the undersurface of the LC-DCP improved blood circulation. There is decreased damage to contact between plate and bone. It also allows for a small bone bridge beneath the plate at the most critical area, which is otherwise weak due to a stress concentration effect. This study is undertaken to assess the results of diaphyseal fractures of Bones of Forearm using LCDCP to study the advantages and its complications.Materials and Methods: Patients admitted to Cg Hospital and Bapuji Hospital between 2019 July to 2020 September were taken into the study after taking informed consent.Results: This study consists of 30 cases of fracture Both Bone Forearm Fractures. All cases were openly reduced and internally fixed with 3.5 mm LCDCP. Fracture was common in second and third decade. In our study, male preponderance was found with 73.3% males and 26.7% female patients. Side affected 24(80%) Left side and 6 patients (20%) right side. Mode of injury in the present study was RTA (33.3%) and fall (66.6%). An average time for union was around 5 months. Results were evaluated by Andersons scoring system. In present study, we had 24 patients (80%) with excellent results, 5 case (16.6%) as satisfactory and 1 case (2%) as unsatisfactory. No case needed refixation. In the present study there was 3 case (10%) of superficial infection, 1 case (3.3%) of Posterior Interosseous Nerve injury. Conclusion: LC-DCP can be considered the best mode of treatment for closed diaphyseal fractures of both bones forearm.

Surgical management of adolescent both bone forearm fractures using a plate and screws versus an intramedullary elastic nail

Surgical management of adolescent both bone forearm fractures using a plate and screws versus an intramedullary elastic nail

Management of both forearm bone diaphyseal fractures - ORIF v/s CRIF v/s hybrid fixation: An operative dilemma

Introduction: Long bone fracture of forearm is common skeletal injury. The most common causes of such injuries include road traffic accident, fall or direct trauma, amongst the various types of forearm fractures, both-bone diaphyseal forearm fractures in adults are frequently met by the orthopaedic doctors. There are various methods available for fixation of both bone diaphysial fractures like both bone plate fixation, both bone intramedullary nailing and hybrid method with nailing in one of the bones and plating in other. Our aim of the study is which method of fixation is most clinically justifiable in both bone diaphysial fractures amongst all the available choices. Materials and Methods: This is a retrospective study of 200 cases of diaphyseal fractures of radius ulna selected randomly over a period two year from March 2016 to March 2018 conducted at civil hospital Ahmedabad. All patients were followed up for a period 6 months post operatively. Result and Conclusion: After studying result of all four method of fixation hybrid fixation showed good union rate, less chance of infection, less chance of malunion and non union,relatively good stability, less incidence of swelling and better recovery with a less chance of implant removal incidence and failure. Keywords: Radius ulna fracture, Plating nailing, Both bone diaphyseal fracture.

Study on Clinico-Demographic Characteristics of Orthopaedic Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Orthopedic conditions include a range of condition varying from traumatic injuries, congenital anomalies, chronic back-pain, arthritis, rheumatologic conditions, and other. In Nepal, approximately 2.35 million people are living with musculoskeletal conditions in which 175,000 people are suffering with MSD from non-traumatic causes. The aim of the study is to observe the clinical and demographic pattern of orthopedic problems presenting in the hospital. A descriptive cross-sectional study was done in All Nepal Hospital Private Limited in the month of November. The data from the medical record section was retrospectively collected. Sample size of 384 was included and convenience sampling technique was used. The descriptive statistical analysis was done. Eight hundred forty four cases were included in the study. Implant removal was the main condition for admission in the hospital 105 (12.44%) followed by Forearm Bone Fracture 84 (9.95%) and Cut Injury 64 (7.58%). Most cases presented during the time 6 PM to 12 AM 312 (36.96%). Most of the orthopedic cases presented in the evening and night time. Implant removal, forearm bone fracture and cut injury form the major bulk of the cases.

Elastic intramedullary nailing in paediatric diaphyseal both bone forearm fractures

Both bone forearm fractures are prevalent orthopaedic injuries. Optimal treatment in paediatric population remains conservative management with closed reduction and immobilization with above elbow cast application. Although fracture unites readily with acceptable alignment due to structural realignment owing to its ability to remodel with remaining growth, malunion is very common. Stiffness of joints and compartment syndrome are other complications with conservative management. Irreducible, unstable, and open fractures usually require operative stabilization with K wires, Plate and screws, or intramedullary nailing. Plating has the advantage of being familiar to many surgeons and theoretically superior in its ability to restore radial bow with added disadvantages. Recently intramedullary nailing has changed the treatment scenario of diaphyseal both bone fractures in the children and adolescents. The study aims to analyze the outcome and complications after elastic stable intramedullary nailing in paediatric diaphyseal forearm fractures. Material and methods: Our series present 23 patients aged 5-15 years with displaced both bone forearm fractures with closed reduction and elastic stable intramedullary nailing under the C arm image intensifier. Among 23 patients, 15 patients were males, and 8 were females with a mean age of 11 years having 4 cases as open fractures. Result: Most of the fractures healed within 5-8 months. We analyzed the results using the reference to union, symptoms, and range of motion of adjacent joints using Price et al. criteria for outcome evaluation. In our series, 18 cases (78.26%) had excellent, 3(13.04%) cases had good, 1(4.34%) case had fair, and 1(4.34%) had poor result due to delayed union. There was one case of delayed union, one case of transient palsies of the superficial radial nerve and 1 case with skin irritation over prominent ulnar hardware requiring early removal and infection in external nail insertion site in Radius in 1 patient and one case of tendon injury. At the final follow up after 8-9 months, we did implant removal with pain-free and without limitation of ADL. Conclusion: One can achieve better functional and cosmetic outcomes by elastic stable intramedullary nailing. It is simple, cost-effective, less time consuming and having fewer complications.

Comparative study on the complications of antebrachium fractures treated with flexible nailing in paediatric and adolescent age group

Background: Antebrachium fractures in paediatric age group, which are unstable are more commonly treated nowadays using intramedullary titanium elastic nailing. Recent studies have showed a higher complication rates in adolescent population when compared to the paediatric counterpart. The aim and objective of this study is to compare the complication rates and outcome in paediatric and adolescent population treated using flexible nail. Methods: An ethical committee approved study was conducted in Rajah Muthiah Medical College, Chidambaram from May 2018 to September 2020 on both bone forearm fractures in paediatric and adolescent population. In our study 20 cases of both bone forearm fractures, of which 10 belonging to paediatric age group (age less than 10 years) and 10 cases belonging to adolescent age group (age more than 10 years) treated with flexible intramedullary nail (TENS). These cases were followed up for period of 1 year and complications were quantified on the basis of Clavien – Dindo classification. Outcomes were analysed based on Martus et al. grading system. Results: Out of 20 forearm fractures treated with tens nail in each age group, mean age was found to be 13.6 years in adolescent group and 9.2 years in paediatric group. Mean follow up period were42 weeks in adolescent category and 40 weeks in paediatric category. Average time and duration from the point of injury to the surgical procedure was 2 to 3 days in both groups. Closed reduction and internal fixation with tens nailing was done in 13 cases (8 paediatric and 5 adolescent group) and open reduction was needed in the remaining 7 cases (2 paediatric and 5 adolescent). The overall result of our study showed that complications were slightly higher in adolescent age group, when compared to the paediatric counterparts. P value between the two groups was not significant. Conclusion: Tens nailing is an excellent technique for paediatric and adolescent fractures of forearm with very good functional outcome. Even though complications were seen in adolescent age group, it was significantly lower than those associated with other surgical techniques. However, with lesser complication rate in paediatric age group, we conclude that in fractures requiring surgical fixation, TENS nailing is more advantageous than other surgical options.

Minimally invasive (Titanium elastic nailing system) operative technique in pediatric both bone forearm fractures

Background: Both bone forearm fracture in paediatric population is one of the most common fractures encountered. Here we present a prospective study conducted to evaluate radiographic & functional outcome of paediatric both bone forearm fractures treated with titanium elastic nailing systems. Methods: In our prospective study we included 18 patients who were between 6 – 15 years, admitted during October 2019 to June 2020 in Chamarajanagar institute of medical sciences & Karwar institute of medical sciences, patients were included according to inclusion & exclusion criteria. All patients were operated under appropriate anaesthesia. Outcome was evaluated using price et al. criteria. All the patients were operated using minimally invasive system (titanium elastic nailing). Results: we included 18 patients, out of which 13 (72.2%) were male & 5(27.7%) were female with male predominance, 10 (55.5%) patients had displaced fracture, 8 (44.4%) had loss of reduction due to unstable & irreducible fracture. 15 (83.3%) patients had right side involvement & 3(16.7%) had left side involvement, closed reduction & internal fixation done in 14 (77.7%) patients were as 4 (22.2%) patients were treated with minimal open reduction & internal fixation, due to irreducibility. Depending on location of fracture 16(88.8%) were in middle 1/3rd, 2(11.1%) were in distal 1/3rd. patients were analysed depending on Price et al. criteria in whom 15 had excellent, 2 had good, 1 had fair result due to local infection & implant prominence. Patients were regularly evaluated at 4, 8 & 12 weeks, finally at 6 months. Union was seen in an average around 4 – 6 weeks. Conclusions: Minimally invasive technique (Titanium elastic nails) for paediatric forearm fractures revealed several advantages, a small incision for insertion, a low rate of complications, good bone healing, and good clinical and radiological results thus achieving maximum range of motion at the earliest.

Functional outcome of flexible nailing in unstable fractures of both bones of forearm in paediatric population

Aim and Objective: Antebrachium fractures are one of the common fractures in paediatric population. Fractures of forearm comprises of about 40% in the fractures of paediatric population [1]. These fractures usually have a high degree of remodelling potential and are usually managed non operatively by closed reduction and maintaining it in a plaster cast. Nowadays the trend for management of these fractures changes towards operative management because of increasing complications by nonoperative methods. The aim of this study is to evaluate the functional outcomes of unstable both bone forearm fractures treated operatively using titanium elastic nailing. Materials and Methods: Study was conducted in the department of orthopaedics at Rajah Muthiah Medical College and Hospital. Total of 20 patients aged were treated using TENS. Closed reduction with internal fixation under c-arm guidance was done in 13 cases and open reduction with internal fixation was done in 7 cases.Results: Patients were followed up for a period of 6 months. Results were analysed with respect to union of fracture, symptoms with activities, range of motion of joints adjacent to the fracture using Price et al. criteria and Anderson et al. criteria. In all cases fractures united at an average of 8 - 10 weeks without any malunion. All 20 cases had excellent outcomes. 3 patient had nail prominence on the ulnar entry side leading to superficial pin site infection.Conclusion: Fixation of both bone fractures of forearm using titanium elastic nailing systems showed many advantages over the conventional plating methods, in terms of smaller incision, minimal soft tissue meddling during fracture fixation, prompt osseous healing, maximum range of motion at the earliest, decrease in complication rate with excellent clinical and radiological results. Thus, titanium elastic nailing used intramedullary is an effective treatment option for the treatment of unstable both bone forearm fractures in paediatric population.

Forearm bone mineral density and fracture incidence in postmenopausal women with osteoporosis: results from the ACTIVExtend phase 3 trial

SummaryAbaloparatide increased ultradistal radius bone mineral density (BMD) in the Abaloparatide Comparator Trial in Vertebral Endpoints (ACTIVE) trial. Over the subsequent 24 months in ACTIVExtend, ultradistal radius BMD gains were maintained with alendronate. Conversely, 1/3 radius BMD remained stable during ALN treatment in ACTIVExtend after decreasing during ACTIVE.IntroductionAbaloparatide (ABL) increased femoral neck, total hip, and lumbar spine bone mineral density (BMD) in postmenopausal women with osteoporosis and decreased the risk of vertebral and nonvertebral fractures in ACTIVE. Effects on fracture risk and BMD were maintained subsequently with alendronate (ALN) in ACTIVExtend. In a prespecified subanalysis of ACTIVE, ABL also increased BMD at the ultradistal radius. Our objective was to determine the efficacy of ABL followed by ALN vs placebo (PBO) followed by ALN on forearm BMD and fracture risk over 43 months in ACTIVExtend.MethodsUltradistal and 1/3 radius BMD (ACTIVE baseline to month 43) were measured (ABL/ALN, n = 213; PBO/ALN, n = 233). Wrist fracture rates were estimated for the ACTIVExtend intent-to-treat population (ABL/ALN, n = 558; PBO/ALN, n = 581) by Kaplan-Meier (KM) method.ResultsAt cumulative month 25, mean increase from ACTIVE baseline in ultradistal radius BMD was 1.1% (standard error, 0.49%) with ABL/ALN vs − 0.8% (0.43%) with PBO/ALN (P < 0.01). BMD increases with ABL were maintained with ALN through month 43 in ACTIVExtend. BMD decreases at the 1/3 radius in ACTIVE (similar with ABL and PBO) were maintained through 24 months of ALN treatment in ACTIVExtend. Wrist fractures over 43 months occurred in 15 women with ABL/ALN (KM estimate, 2.8%) and 20 with PBO/ALN (KM estimate, 3.6%) (HR = 0.77, 95% CI 0.39, 1.50; P = not significant).ConclusionUltradistal radius BMD gains following treatment with ABL in ACTIVE were maintained over 24 months of ALN treatment in ACTIVExtend. Conversely, 1/3 radius BMD remained stable during ALN treatment in ACTIVExtend after decreasing during ACTIVE.Trial registrationClinicalTrials.gov: NCT01657162 submitted July 31, 2012

Synostosis after fracture of both forearm bones treated by intramedullary nailing

This study evaluated the risk of radioulnar synostosis after fracture of both forearm bones at the same level. We hypothesized that (i) the incidence of synostosis in both-bone forearm fractures at the same level is low with intramedullary nailing (IMN); (ii) the type of fracture (open/closed) and type of reduction (open/closed) affect time to union. Seventy-eight patients who had been treated with IMN for fracture of both forearm bones and had at least 1 year of follow-up were included in the study retrospectively. All the patients were treated by IMN following closed reduction or open surgery. Patients were followed clinically and radiologically. Age, open or closed fracture, time to union, and occurrence of synostosis were documented. The mean age of the patients was 33.4 years. Fifty-three (68%) patients were male. Forty-eight (61.5%) patients had high velocity injuries. The mean follow-up was 26.4 (12–46) months. According to the Grace and Eversmann scoring system, 95% had good or excellent outcomes. The mean DASH score was 10.5 (0–56). Union rate was 100%. Only one patient (1.2%) had a radioulnar synostosis at middle third level. IMN is a safe method that yields a high union rate and contributes to a low incidence of synostosis. Open fracture and open reduction during surgery have no effect on time to union.

Evaluation of outcome of fracture of adult diaphyseal forearm bones treated by nailing and plating

Evaluation of outcome of fracture of adult diaphyseal forearm bones treated by nailing and plating

The Outcome of Myringoplasty with d without Cortical Mastoidectomy Comparative Study between Elastic Nail Versus Plates and Screws in the Treatment of Diaphyseal Both Bone Forearm Fracture in Children

The Outcome of Myringoplasty with d without Cortical Mastoidectomy Comparative Study between Elastic Nail Versus Plates and Screws in the Treatment of Diaphyseal Both Bone Forearm Fracture in Children

Intramedullary Fixation of Both Bone Forearm Fractures in Children and Adolescents: Healing Correlates With Development of the Olecranon Apophysis.

The purpose of this study was to determine whether healing of both bone forearm (BBFA) fractures in children and adolescents is associated with the stage of the olecranon apophysis development as described by the Diméglio modification of the Sauvegrain method. Records were reviewed from 2 children's hospitals from 1997 to 2008 to identify all patients younger than 18 years of age who had BBFA fractures treated with intramedullary nail fixation. Sixty-three patients were identified meeting inclusion and exclusion criteria. The stage of the olecranon apophysis was noted on the lateral radiograph at the time of the injury. Data were statistically analyzed to assess the olecranon stage at which the increased rate of delayed union becomes more prevalent using the receiver operating characteristic curve. Time to union, complications, and need for reoperation were recorded for each group. One thousand three hundred ninety-eight patient records were reviewed with 63 patients meeting the inclusion criteria. Using a receiver operating characteristic curve, a cutoff of olecranon stage > 3 (stages 4 to 7) was a significant predictor of the increased rate of delayed union time compared with olecranon stages 0 to 3 (P=0.004). Non-healing-related complication rates for each group were 2/28 (7.1%) for olecranon stages and 0 to 3 and 6/35 (17.1%) for olecranon stages 4 to 7. The rate of delayed union for BBFA fractures that have been treated with intramedullary nail fixation is increased in children with more mature olecranon apophyses as compared with those with younger olecranon stages. We propose the use of the stage of olecranon apophysis development when choosing the surgical approach and implant for when treating operative BBFA fractures in children. Level III-retrospective comparative study.

Comparative Study between Elastic Nail Versus Plates and Screws in the Treatment of Diaphyseal Both Bone Forearm Fracture in Children

Comparative Study between Elastic Nail Versus Plates and Screws in the Treatment of Diaphyseal Both Bone Forearm Fracture in Children

Comparative study of functional outcome after internal fixation of comminuted fractures of diaphysis of the forearm with locking compression plate and dynamic compression plate

Introduction: Management of fractures of a forearm over time reflects the evolution of modern Orthopaedics. With the introduction of internal fixation, many surgeons reported encouraging results. The locking compression plate (LCP) and Dynamic Compression Plate (DCP) are newer modalities for fracture fixation of both bone forearm fractures. The study aimed to compare functional outcome after internal fixation of comminuted fractures of diaphysis of the forearm with LCP and DCP. Methodology: It is a prospective type of comparative study involving 30 patients attended orthopedic casualty due to fractures of diaphysis of the forearm. After primary emergency management, a splint was applied; a radiological examination of the affected limb was carried to assess the fracture type. Alternate patients are fixed with LCP and DCP randomization. All patients were personally examined at follow up on the second, fourth, sixth month, and one year. The functional and radiographic results were recorded according to Anderson et al. criteria. Handgrip assessed and compared to the opposite limb. Results: Our study reports that younger patients have shown statistically significant good results compared to older patients (p-value-0.013). Prognosis with sex and type of fracture was not statistically significant. Early fixation gives good result, and it is statistically significant (p-value- 0.008). Even though clinically LCP gives better results compared to DCP it is not statistically significant in single fracture (p-value-0.06), but LCP gives better results in both bones forearm, and it is statistically significant (p-value-0.034). The present study had a union rate of 96.66%, with a mean time of union in the LCP group was found to be lesser in comparison to DCP group. All both bones fractures treated with LCP showed callus formation, and 75% of both bones treated with DCP showed callus formation, and it is statistically significant (p-value-0.05). Overall, the patients were satisfied

Evaluation of Clinical Outcomes of Management of Pediatric Both Bone Forearm Fractures Using the Titanium Elastic Nailing System: A Prospective Study of 50 Cases

Context: Forearm fractures are common injuries in children. In older children, their management is difficult due to increased chances of redisplacement after closed reduction. Aims: The aim of this prospective study was to evaluate the clinical outcome of managing pediatric forearm fractures using the titanium elastic nailing system (TENS). Subjects and Methods: Fifty patients in the age group of 6–14 years with fractures both bones forearm were managed by internal fixation using the TENS, and prospective follow-up was done for 6 months. Results: On final evaluation, we had excellent outcomes in 92% patients and good in 8%. There were no significant complications except for superficial pin-tract infections at entry site of nail in only 6% of patients. Conclusions: We conclude that TENS is an effective and minimally invasive method of fixation of forearm fractures with excellent results in terms of bony union and functional outcomes with minimal complications and without jeopardizing the integrity of the physis.

A Review of Surgical Management Affecting Forearm Rotation after Both Bone Forearm Fracture in the Pediatric Athlete: Plate versus Nail

A Review of Surgical Management Affecting Forearm Rotation after Both Bone Forearm Fracture in the Pediatric Athlete: Plate versus Nail