Operative Indications in Fractures of Both Bones of the Forearm

¹ An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons

In adults better results will be obtained if fractures of both bones of the forearm with displacement are treated by open operation rather than by repeated attempts at closed manipulation or by use of skeletal traction. Skeletal traction through the metacarpal bones frequently leads to complications its the hand that nullify any advantage that may be obtained from the traction so far as the reduction of the fracture of the forearm is concerned.

Fractures of both bones of the forearm take longer to heal than is usually realized. The common error made by all of us is that, in our enthusiasm to get a patient back to work, immobilization is discontinued too soon, and a secondary deformity occurs in a fracture which is not completely solidified. Usually, immobilization is required for a minimum of three to four months. Of course, the time depends on the age of the patient, the type of fixation, roentgenographic findings, and the judgment of the surgeon.

The management of fractures of both bones of the forearm depends a great deal on the judgment, experience, and skill of the surgeon. It is similar to golf in which one depends on his own experience to know what club is most suitable in his hands to perform a successful shot to the green. No two golfers, including the professionals, use exactly the same club, at the same distance, under the same circumstances. So it is in management of fractures of both bones of the forearm. The individual surgeon must evaluate each case based on his own skill and past experience.

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