Introduction: The distal forearm is the most common fracture site in children. The stresses from a fall on the outstretched hand are prone to result on a physeal or metaphyseal fracture of the distal radius. Fortunately subsequent growth disturbance is unusual. Our aim is to report the advantages or disadvantages of the Kapandji method compared with the crossed pin fixation.

Materials and Methods: We reviewed 29 children brought to the operating room for reduction and percutaneous fixation of distal forearm fractures during the last 18 months. There were 23 boys and 6 girls aging between 4 and 15 years old. Fractures were classified in four general types: physeal, torus, greenstick and complete. Sixteen fractures were fixed using the Kapandji technique and 13 were fixed with crossed pins.

Results: All patients recovered full range of motion. None of the fractures required open reduction. Pinning using the Kapandji technique was easier and took about 50% less of the operating time. Nevertheless we found that there was no leading criteria to decide which were the fractures that would need pinning after reduction. There was an incidence of 10% of superficial infections that subsided after removal of the wires with no further complications in both methods.

Conclusions and Discussion: Radial collapse, loss of wrist motion, and distal radioulnar joint dysfunction, all common problems associated with distal radius fractures in the adult, are rarely seen after children’s distal radial fractures. Closed reduction is usually easy. Although the final results were the same comparing crossed pin fixation and the Kapandji method, the later proved to be easier and less time consuming in the operating room. For this reason we favour this type of fixation for the distal forearm fractures in children.

Introduction – Elbow dislocation in children is a rare lesion and most of the times is associated with a fracture of the medial epicondyle. When there is a fracture of the radial neck it is even more rare and usually represents a major instability with large soft tissue disruption.

Methods – Between 1984 and 2003, 56 patients with unilateral elbow dislocations were identified ranging from 4 to15 years of age. In 8 patients a radial neck fracture was associated and in two there was a radio ulnar translocation . All these patients were treated the same way: closed reduction of the fracture dislocation under general anesthesia, evaluation of the instability and fracture fixation by closed means (Metaizeau technique). No ligamentous reconstruction was performed even in the presence of severe instability after bone reconstruction. A plaster was applied for two weeks followed by active mobilization.

Results – All fractures healed with no complications. All patients except one regained full range of motion. The patient with a loss of extension (20°) complaints of pain on the lateral side during sports activity and has a minor instability test positive for the lateral collateral ligament.

Discussion – This is a rare lesion in children not well documented in the literature. In the adult population there is an emphasis on the necessity of a repair of the soft-tissue structures as an integral part of the surgical strategy for elbow dislocation that require operative treatment (Mckee et al. J Shoulder Elbow Surg. 2003 Jul–Aug;12(4):391–6). In this small series we found no major instability in a long follow-up study even without reconstruction of the soft-tissues.

Conclusion – We concluded that in this particular type of lesion, a close anatomical reduction of the articular surfaces with restoration of the normal relationship around the elbow was fundamental to restore elbow stability with no need for soft-tissue reconstruction