Clin Orthop Surg.  2018 Jun;10(2):265-268. 10.4055/cios.2018.10.2.265.

Traumatic Absence of the Shaft of the Radius in a Child: A 15-Year Follow-up after Reconstruction by a Modified Define's One Bone Forearm Procedure

• Moon MS
• Kim DH
• Moon YW
• Kim SS
• Moon HL
• Kim SS

• KMID: 2411755
• DOI: http://doi.org/10.4055/cios.2018.10.2.265

Abstract

Traumatic absence of the entire radial shaft in children has not been reported though there are a few reports of adult cases. We report a 5-year-old boy with traumatic absence of the entire right radial shaft. The Define's reconstruction procedure was chosen to localize the surgery only to the distal forearm and avoid further additional damage to the forearm muscles. The child's forearm was successfully reconstructed by the authors' modified Define's procedure, which was followed until his maturity. Hand function was well maintained.

Keyword

Absence; Radial shaft; Traumatic; Reconstruction; Child

MeSH Terms

Adult
Child*
Child, Preschool
Follow-Up Studies*
Forearm*
Hand
Humans
Male
Muscles
Radius*

Figure

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  Fig. 1 Diagram illustrating the method of transposition of the osteotomized ulna to the radius.

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  Fig. 2 Radiographs taken at initial visit on March 18, 1977 showing the loss of right radial shaft and elbow dislocation.

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  Fig. 3 (A) Radiographs showing the transplanted osteotomized distal ulna to the remaining distal radial metaphysis after the modified Define's procedure. (B) Nonunion of the ulna transposed to the radial metaphysis is shown.

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  Fig. 4 Radiographs taken on January 10, 1979 showing the periosteocorticocancellous bone graft to the nonunion site which was fixated with two Kirschner wires.

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  Fig. 5 Final follow-up radiographs taken on June 22, 1992 at the age of 20 years. The reconstructed right forearm showed the bifurcated distal ulna without wrist deformity despite some shortening of the forearm (17.5 cm, A) compared to the normal left forearm (27.5 cm, B).

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