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Midshaft forearm fractures in children

Paula Schweich, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


Midshaft fractures of the forearm will be addressed here. The diagnosis and management of distal forearm fractures in children and other upper extremity fractures are discussed separately. (See "Distal forearm fractures in children: Initial management" and "Evaluation and management of supracondylar fractures in children" and "Midshaft humeral fractures in children".)


Forearm fractures are the most common fractures in children, representing 40 to 50 percent of all childhood fractures [1,2]. In one large series, forearm shaft fractures of the radius ranked as the third most common fracture after distal radial fractures and supracondylar humeral fractures [3]. In addition, midshaft forearm fractures are the most common sites for refracture in children and among the most common sites of pediatric open fractures [4].

Forearm fractures have been associated with falls from playground equipment (eg, monkey bars) and from backyard trampolines [5,6]. However, any fall with adequate force may result in fracture.


The bones, muscles, ligaments, and tendons all work together in stabilizing the forearm. An interosseous membrane connects the radius and ulna, and the radius rotates around the ulna during supination and pronation of the forearm (figure 1 and figure 2) [1,7-10]. The two areas where the radius and ulna meet, at the elbow and the wrist, are called the radioulnar articulations. Because of the interosseous membrane and these articulations, any disruption or fracture of one bone is usually accompanied by fracture to the other (image 1) [1,4,9].

If only one bone appears to be fractured, the clinician should check the proximal and distal joints for injury to the other bone or the joint.

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Literature review current through: Nov 2017. | This topic last updated: Apr 24, 2017.
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