The preferred treatment of the simple fractures of the radius in these injury configurations is compression plating (with or without lag screw), leading to absolute stability and direct bone healing.
The preferred treatment of the bifocal fractures of the ulna is compression plating leading to anatomical restoration of length, rotational alignment, and absolute stability. The blood supply of the intermediate fragment must be meticulously preserved throughout.
In certain circumstances, compression plating of the ulna may not be achievable and other management options should be considered.
Some segmental fractures cannot be treated by compression plating for technical reasons and occasionally, bridge plating of the ulna is indicated; in such circumstances, the blood supply of the intermediate fragment must be meticulously preserved.
Anatomical reduction cannot be achieved in fragmentary segmental fractures of the ulna, but maintaining relative stability using bridge plating is widely accepted. Either a conventional plate, or a locked plate, can be used as long as the principles of minimizing soft-tissue stripping and achieving both length and alignment are respected.