Hybrid Fixation in Pediatric Forearm Fractures, does it Predispose to Non-union? A Case Report and Literature Review

INTRODUCTION: Pediatric fracture non-union is rare, with limited published evidence available. Whilst there have been certain predisposing factors identified throughout case reports/series, we present a case, hypothesizing a previously undocumented risk factor for non-union. CASE REPORT: A 9-year-old boy sustained closed, diaphyseal both bone forearm fractures. He underwent a hybrid fixation (plate fixation of the ulnar and elastic stable intramedullary nail of the radius). Whilst the ulnar fracture healed well, the radial fracture went on to non-union before a second procedure was performed, metalwork removed, and a compression plate utilized. At 2-month post-radial compression plate, there was a union at this site. CONCLUSIONS: There are numerous risk factors for non-union in pediatric fractures which have previously been highlighted throughout literature. We present a case hypothesizing a new risk factor, of hybrid fixation, for pediatric non-union.