M.E.Müller: Atlas: Fracture 22-C3

Radius/Ulna, Diaphysis,
complex fracture,
both bones 0,05% of the total
0,40% of the radius/ulna
1,64% of the segment

3 fractures 10,7% group 33%M, 67%F

7 fractures
25,0% group
100%M, 0%F

60 fractures
19,0% group
58%M, 42%F

Segmental Segmental of the one, irregular of the other +Q Irregular

These are complex fractures of both bones of the forearm, segmental of one of them and irregular of the other (C3.2)or irregular of both bones (C3.3). Ref. Manual of Internal Fixation:
232 - 251. 466 - 475.
Surgeon. MS, RO, RO.

The treatment is based on obtaining the best possible reduction with the lesser possible surgical aggresion and placing alignment bridge plates without interfering with the blood supply of the intermediate fragments. The main difficulty of the preoperative planning is to decide which one of the two bones will be easier to reconstruct to its original lenght. Preferably, the ulna should be chosen. Sometimes, the anatomic curvature of the radius will have to be “invented” because of the impossibility to visualizing it without interfering with the blood supply. Autologous cancellous bone graft must always be used.

The illustrated C3.2 case, provisionally stabilized with an external fixator, shows a closed segmental fracture of the

radius. The intermediate fragment has a long bevel edge that could be fixed to the main distal fragment with a lag screw. Once the fracture was simplified, a plate with axial compression and neutralization effects was placed and the curvature of the radius was reconstructed.

The largely open fracture of the ulna was provisionally stabilized with an intramedullary Kirschner wire that 4 weeks later was substituted by a straight plate and autologous cancellous bone graft. The intramedullary wire is a compromise solution, useful as an intermediate stage between the external fixator, healing of the soft tissues and definitive internal fixation.

preoperative preoperative + 1 year 6 months + 1 year 6 months

preoperative postoperative

preoperative + 5 months




						Radius/Ulna, Diaphysis, complex fracture, both bones	0,05% of the total 0,40% of the radius/ulna 1,64% of the segment






These are complex fractures of both bones of the forearm, segmental of one of them and irregular of the other (C3.2)or irregular of both bones (C3.3).		Ref. Manual of Internal Fixation: 232 - 251. 466 - 475. Surgeon. MS, RO, RO.

The treatment is based on obtaining the best possible reduction with the lesser possible surgical aggresion and placing alignment bridge plates without interfering with the blood supply of the intermediate fragments. The main difficulty of the preoperative planning is to decide which one of the two bones will be easier to reconstruct to its original lenght. Preferably, the ulna should be chosen. Sometimes, the anatomic curvature of the radius will have to be “invented” because of the impossibility to visualizing it without interfering with the blood supply. Autologous cancellous bone graft must always be used. The illustrated C3.2 case, provisionally stabilized with an external fixator, shows a closed segmental fracture of the	radius. The intermediate fragment has a long bevel edge that could be fixed to the main distal fragment with a lag screw. Once the fracture was simplified, a plate with axial compression and neutralization effects was placed and the curvature of the radius was reconstructed. The largely open fracture of the ulna was provisionally stabilized with an intramedullary Kirschner wire that 4 weeks later was substituted by a straight plate and autologous cancellous bone graft. The intramedullary wire is a compromise solution, useful as an intermediate stage between the external fixator, healing of the soft tissues and definitive internal fixation.