REAPPROXIMATING MID FOREARM FRACTURES THROUGH ANGULATION

A patient presents with a mid forearm fracture. Reduction is tough because it is 100% displaced. Unlike distal fractures, you can not grab the bone as it is surrounded by muscle. It is hard to pull enough traction to reapproximate. Now what?

 

Try angling more during your reduction, exaggerating the angulation. Now it is slack enough you can put the distal piece on the proximal piece. Use your other hand to guide it on manually. Once the two pieces touch each other, simply straighten the bone out.

 

You try this and are able to secure adequate reduction. The patient now has a better chance of receiving adequate reduction without surgery.

 

TAKE HOME POINTS

If you can not pull traction to reapproximate fractures, try angling the fracture to give it slack, then fit the fragments together before restoring alignment.

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