Ununited Fracture of the Forearm, with Deficiency of the Ulna, Treated Successfully by Excision and the Wire Suture

T. Annandale
1875 BMJ (Clinical Research Edition)  
Surgeon to the Edinburgh Royal Infirmary and Lecturer on Clinical Surgery. R. K., aged 29, was admitted into my wards on June 24th, I873, suffering from an ununited fracture of the bones of the forearm. About six months before his admission, bis forearm had been severely injured by machinery. Both bones were fractured, and a large lacerated wound was caused by the accident. He was taken to a provincial hospital, and carefully treated for several months. About three months after the accident, a
more » ... er the accident, a large piece of bone (a portion of the ulna) gradually loosened, and was removed. Three weeks after this, the wound was healed, but the bones had not united properly. When the arm was examined, a large cicatrix was noticed over the middle third of the bones of the forearm; it was adherent to the ulna for a short distance, but was otherwise free. Both bones were movable at the junction of their middle and lower thirds, but the radius less so than the ulna. The ulna was not only quite ununited, but was deficient for about one inch at the seat of fracture, the result, no doubt, of the necrosis which had followed the injury. The fractured ends of the ulna were displaced towards, anid adherent to, the radius. Pronation and supination could not be performed, and the arm was also weak, and, in consequence, useless. On June 27th, I performed the followina operation, with the hope of making the arm more useful. An incision, about three inches long, was made over the dorsal aspect of the ulna, so as to expose the fractured portion of this bone. It was then found that the fractured ends were rounded off and atrophied, and united to one another and to the
doi:10.1136/bmj.1.732.38 fatcat:mgltu4dkdffevafcc5cetfub2m