Non-operative Management of Adult Both Bone Forearm Fractures - A Case Report and Literature Review

Abstract

Introduction: Adult both bone forearm fractures (BBFF) are common injuries that are typically treated with operative fixation given their instability. Non-displaced fractures can be theoretically treated non-operatively, but there is no literature demonstrating treatment outcomes of such fractures.

Case report: We present a case of non-displaced BBFF in a 23-year-old Caucasian male adult who was treated with cast immobilization and concomitant ultrasound stimulator use; this patient went on to have solid fracture healing without complication.

Conclusion: Based on this case, we demonstrate that non-operative management of non-displaced BBFF in adult patients is an option if close follow-up is available. This is significant for the fields of both orthopedic and plastic surgery, as there is little concrete evidence of outcomes of such non-displaced fractures in hand surgery literature.

Keywords: Both bone forearm fractures; adult fracture; bone stimulator; non-operative management; radius and ulna fracture.

Figure 1

AP (a) and lateral (b) X-rays demonstrate non-displaced fractures in the proximal third of the radius and ulna with minimal comminution.

Figure 2

AP (a) and lateral (b) X-rays demonstrate the both bone forearm fractures with interval cast placement without any new fracture displacement or angulation.

Figure 3

AP (a) and lateral (b) X-rays demonstrate the same fractures with interval callus formation without significant change in fracture angulation or displacement 1 month after injury. Note the window cut out of the cast at the level of the fracture to allow for ultrasound stimulator use.

Figure 4

AP (a) and lateral (b) X-rays demonstrate the same fractures with complete bony callus formation 3 months after injury.