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Cross-union complicating fracture of the forearm. Part II: Children

The Journal of Bone & Joint Surgery.  1987; 69:654-661 
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Abstract

Cross-union is a rare complication of fractures of the forearm in children. Of the ten cross-unions reported in this series, four were Type 2 (middle third or non-articular part of the distal third of the radius and ulna) and six were Type 3 (proximal third of the forearm). There were no Type-1 (intra-articular part of the distal third of the radius and ulna) cross-unions. As in adults, the Type-2 cross-unions followed a high-energy injury. Three of the four Type-2 cross-unions were excised; one of them recurred. Type-3 cross-unions occurred equally after closed or open reduction of a fracture. Three patients with a Type-3 cross-union had excision of the radial head. The only patient who did not have a recurrence of the cross-union also underwent insertion of a prosthesis for the radial head. The results after resection of a cross-union appear to be better in the adult than in the child, although the number of patients in this and other studies is too small to allow firm conclusions.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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