The Journal of Bone and Joint Surgery, Vol 69, Issue 5 654-661, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Cross-union complicating fracture of the forearm. Part II: Children
KG Vince and JE Miller
Cross-union is a rare complication of fractures of the forearm in children.
Of the ten cross-unions reported in this series, four were Type 2 (middle
third or non-articular part of the distal third of the radius and ulna) and
six were Type 3 (proximal third of the forearm). There were no Type-1
(intra-articular part of the distal third of the radius and ulna)
cross-unions. As in adults, the Type-2 cross-unions followed a high-energy
injury. Three of the four Type-2 cross-unions were excised; one of them
recurred. Type-3 cross-unions occurred equally after closed or open
reduction of a fracture. Three patients with a Type-3 cross-union had
excision of the radial head. The only patient who did not have a recurrence
of the cross-union also underwent insertion of a prosthesis for the radial
head. The results after resection of a cross-union appear to be better in
the adult than in the child, although the number of patients in this and
other studies is too small to allow firm conclusions.
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