Morote pinning for displaced midshaft forearm fractures in children

Surgical Principles Internal fixation of displaced midshaft or proximal forearm fractures in children or adolescents without violating the epiphyseal growth plate (physis) can be achieved with intramedullary implants. From a distal approach, the displaced fragments of the radius are aligned with the blunt end of a pre-bent Kirschner wire and reduced. In a second step, the ulnar fracture is reduced and fixated intramedullarily through a proximal approach. An external immobilization is advised for two to four weeks. Intramedullary pins or nails for the treatment of forearm fractures have been in use for years. Kirschner wires [1, 2, 3, 4, 6, 12], Rush pins [13] and Hackethal bundle nails [5] were tried. This new technique was first published in the Spanish literature by Perez-Sicilia et al. [11] in 1977. J. L. Morote Jurado introduced us to his method in 1983. A similar principle of treating forearm fractures in children was published by Buch et al. [3]. Elastic intramedullary nails have been used by the school of Nancy [7, 9, 10, 14]. Revised Version from: Operat. Orthop. Traumatol. 2 (1990), 245–255 (German Edition).