Published: 2021-06-23

Bone versus implant: an atypical presentation of a typical complication of forearm fractures

Pulak Vatsya, Anupam Gupta, Samarth Mittal, Vivek Trikha


Both bone forearm fractures are one of the most common upper limb fractures operated by orthopedicians. Although the primary surgery is usually relatively straight forward and simple, but we present a case where the primary surgery failed and the patient presented with a deformed hand after 5 months, even though there were signs of union on radiographs. When operated upon, although the ulna had undergone primary bone healing and a peri-implant fracture had occurred, whereas radius had refractured from the fracture site and the plate was bent giving the deformed appearance. We discuss this unique complication, the planning, difficulties and scope of errors in such a situation, where the race to union is won by ulna but lost by radius.


Trauma, Implant failure, Revision surgery, Non-union, Complications, Both bone forearm

Full Text:



Tornetta P, Ricci W, Court-Brown CM, Heckman JD, McQueen MM, McKee M. Rockwood and Green’s fractures in adults. Lippincott Williams and Wilkins. 2015.

Keogh P, Khan H, Cooke E, Mccoy G. Loss of Flexor Pollicis Longus Function after Plating of the Radius. J Hand Surg Am. 1997;22:375-6.

Anderson LD, Sisk TD, Tooms RE, Park WI. Compression plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Jt Surg. 1975;57:287-97.

Boussakri H, Elibrahimi A, Bachiri M. Nonunion of fractures of the ulna and radius diaphyses: Clinical and radiological results of surgical treatment. Malaysian Orthop J. 2016;10:27-34.

Kloen P, Wiggers JK, Buijze GA. Treatment of diaphyseal non-unions of the ulna and radius. Arch Orthop Trauma Surg. 2010;130:1439-45.

Rosson JW, Shearer JR. Refracture after the removal of plates from the forearm. An avoidable complication. J Bone Jt Surg. 1991;73:415-7.

Brooks DB, Burstein AH, Frankel VH. The biomechanics of torsional fractures. The stress concentration effect of a drill hole. J Bone Joint Surg Am. 1070;52:507-14.

Cheal EJ, Hayes WC, White AA, Perren SM. Stress analysis of compression plate fixation and its effects on long bone remodeling. J Biomech. 1985;18:141-50.

Chapman MW, Gordon E, Zissimos AG. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Jt Surg. 1989;71:159-69.