Both Bone Forearm Fracture

History: 10 year old male status post fall. 

Radiograph of the left forearm shows a both bone (radius and ulna) forearm fracture with ulnar apex angulation and approximately one half shaft width radial displacement of the distal radial fragment and nearly one full shaft width radial displacement of the distal ulnar fragment.

This is the appearance of a both bone forearm fracture in the pediatric patient. The most common mechanism is fall on an outstretched hand, sometimes referred to as FOOSH; however, this mechanism of injury typically causes other types of distal forearm fractures such as a Colles fracture or Smith fracture.

Most of these fractures are treated without surgery via closed reduction and immobilization for 6-12 weeks.

As a side note, this is obviously a skeletal immature patient. How can you tell the age? While there is a wide degree of variation, the carpal bone ossification pattern indicates the patient is likely near 11 years old, as an ossified pisiform is seen.