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Diaphyseal fractures of the forearm have accompanied humanity throughout its history. Nonsurgical techniques dominated the treatment for centuries, and complications including nonunion and malunion were common. The 19th century featured the recognition of distinct injury patterns. With the development of anesthesia and antisepsis, the operative treatment became widespread. In 1878, Heine described fixation of the diaphyseal nonunion of the distal ulna using an intramedullary ivory peg. Parkhill reported on the application of external fixation for forearm fractures in 1897-1898. Hansmann published the case of plate osteosynthesis of an acute fracture of the radius in 1886. In 1913, Schöne published the technique of closed intramedullary fixation of diaphyseal fractures of the forearm using a silver wire. During the first 2 decades of the 20th century, plate osteosynthesis quickly spread across Europe and North America owing to the influence of Lambotte and Lane. After the World War II, plate osteosynthesis became the surgical treatment of choice for forearm diaphyseal fractures., (Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

This research utilized biplanar radiographs to estimate cross-sectional biomechanical properties for the skeletal remains of two elite individuals from the Early Classic period (ca. AD 400-600) of Copan, Honduras: K'inich Yax K'uk' Mo' (Hunal Burial 95-2), founder of the Early Classic Dynasty at Copan, and the primary female interment (Burial 37-8) from the Motmot tomb. Both individuals survived severe blunt-force insults to the right forearm. Gross skeletal examination and evaluation of the radiographs for K'inich Yax K'uk' Mo' suggest that these traumas resulted from, at least in part, disuse atrophy of the affected forearm skeletal elements. Gross and radiologic evaluation of the Motmot remains countered the possibility that she suffered from a metabolic bone disease, and confirmed the presence of a well-healed parry fracture of the right ulna. The degree of asymmetry in cross-sectional biomechanical properties reported here for K'inich Yax K'uk' Mo' is likely the secondary result of the described blunt-force trauma. The results obtained for the principal Motmot interment are not as dramatic, but suggest subtle changes to humeral cross-sectional geometry subsequent to trauma., (2005 Wiley-Liss, Inc.)

Fourteen adult burials in a large (N = 224) prehistoric central California cemetery (CA-SCL-674) lack forearm bones. Twelve of these otherwise well-articulated primary interments have distal humeri bearing cutmarks with a distribution like that seen in fur seals butchered by Native Californians. Most of the burials with missing forearms are young adult males, a demographic profile that differs significantly from the full sample. Three of these males show evidence of perimortem trauma in addition to forearm amputation. Drilled and polished human radii and ulnae were recovered from the CA-SCL-674 cemetery in archaeological contexts separate from burials with missing forearms. A warfare-related trophy-taking practice is strongly suggested by these bioarchaeological data. Based on these data, it seems likely that 20% (N = 10) or more of the adult males (N = 59) in this population were victims of violence. Evidence of perimortem violence was much less common among women, with only about 2% (N = 2) of adult females (N = 86) subjected to trophy-taking. Examination of museum collections produced further evidence for perimortem forearm amputation among the Native American inhabitants of this area during the transition between the Early and Middle periods. The emergence of more hierarchical social systems during this period may have fostered warfare-related trophy-taking as a symbolic tool for enhancing the power and prestige of individuals within competing social groups., ((c) 2005 Wiley-Liss, Inc.)

Although replantation of completely amputated wrists and forearms is now commonplace, in 1965 the replantation of this "wrist level" amputation was the first reported in the western world. The details of the technique used are contrasted with current standard of care.

In the case of fractures of the middle one-third of the forearm that are several weeks old, the procedure is as follows. Use a brachial block or general anesthesia. Open the radial fracture by freeing up the fracture site and clearing the medullary canals. About a 4-cm longitudinal incision is made over the dorsal aspect of the radius at the wrist distant from the fracture and between the tendons of the extensor pollicis longus and the extensor carpi radialis longus and brevis. Make a hole in the radius with a small gouge with insertion of the pin to the fracture site and then drive it into the proximal fragment. Then cut the pin off at the right length and set it into the bone with hammer blows to the driver. Remove the driver. Check the reduction of the fracture and closure of the wound. Repeat the procedure on the ulna with the difference that the trephination of the ulna is done proximally. Apply the splint. The fracture site must be protected carefully to avoid angulation. Should this occur, it can be corrected without opening the fracture site because the pins are flexible. We have operated upon four isolated fractures of the ulna, one isolated fracture of the radius, and two fractures of both radius and ulna. I believe that the procedure is simple and practical to perform. Whether and to what extent a similar procedure can be carried out satisfactorily on other bones with larger marrow canals remains to be seen.