12-D/5.2   Multifragmentary complete fracture

Multifragmentary shaft fractures can be wedge or comminuted (12-D/5.2). These fractures are uncommon and tend to occur in children >12 years as a result of high-energy trauma.

The closer the fracture is to the proximal physis the better the remodeling potential.

Translation remodels completely and is independent of location.

Remodeling of varus deformity is more predictable and whilst there is no functional limitation, persistent angulation of >20° can lead to visible deformity.

Radiological evaluation of rotational malalignment is difficult.

Most fractures can be identified on plain x-rays.

AP and lateral views including the elbow and shoulder are usually sufficient for diagnosis.

Transthoracic x-rays should be avoided where possible.

A single view including the adjacent joints may be sufficient for surgical decision making.