Introduction: Although both-bone forearm fractures in children may result in severe limitation of forearm rotation, finding the cause remains a diagnostic challenge. This study tries to evaluate the role of rotational malunion, bony impingement and contractures of the interosseous membrane. Patients and methods: Children (5-16 years) who suffered from a both-bone forearm fracture in diaphysis or distal metaphysis with a limitation of pronation/supination ≥40 at ≥6 months after trauma were included for analysis with conventional radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Results: A total of 410 children with a both-bone forearm fracture were prospectively followed in four Dutch hospitals. At a median of 205 days, 7.3 % suffered from a limitation of pronation/supination ≥40. 14 children were included (median limitation of 40) and the radiographs revealed a median maximum angular malunion of 16. CT analysis showed rotational malunion of both radius (median 19) and ulna (median 9). MRI analysis revealed neither bony impingement nor contractures of the interosseous membrane. Conclusions: Three-dimensional imaging of children with a severe limitation of pronation/supination after a both-bone forearm fracture revealed rotational malunions of both radius and ulna without bony impingement or soft tissue contractures. Level of evidence: Prospective multicenter study, Level 2.

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doi.org/10.1007/s00402-014-1922-y, hdl.handle.net/1765/61924
Archives of Orthopaedic and Trauma Surgery
Department of Orthopaedics

Colaris, J.W, Oei, S, Reijman, M, Holscher, H.C, Allema, J.H, & Verhaar, J.A.N. (2014). Three-dimensional imaging of children with severe limitation of pronation/supination after a both-bone forearm fracture. Archives of Orthopaedic and Trauma Surgery, 134(3), 333–341. doi:10.1007/s00402-014-1922-y