23-M/3.2   Metaphyseal, multifragmentary complete, both bones

Multifragmentary distal radial and ulnar fractures are very rare, occur in adolescents, and are generally caused by high-energy impact.

The injury is associated with local tenderness over the distal forearm or specifically over the distal radius and ulna. Local swelling is usual. Visible deformity is often present; this is, usually posterior angulation (apex anterior), but may be anterior angulation.

Check elbow for tenderness and range.

An x-ray will show complete fractures, direction of displacement, and complexity of the metaphyseal fragments.