Fracture of the shaft of ulna and radius with associated dislocation of the radial head.

Fourteen cases of fracture of the shaft of ulna and radius with associated dislocation of the radial head in adults are presented. The dislocation was initially missed in 42 per cent of cases. Several closed and open therapeutic procedures were performed either for the dislocation or the shaft fractures. In these patients, with follow-up averaging 5.9 years, the incidence of complications (redislocation, mal-union, pseudarthrosis, radio-ulnar synostosis, peri-articular ossification) was noteworthy. Final evaluation according to the range of motion of the forearm, showed a high incidence of unsatisfactory results. Predisposing to these results were delayed reduction of the dislocation, repeated and forceful manipulation and manual pressure on the radial head, inadequate reduction or stabilization of the fractures and a long period in the plaster cast. Guide lines for early diagnosis and efficient treatment are suggested.