Background : Non-union of ulna in children is uncommon, which is usually associated with neglected monteggia fractures,
osteomyelitis, open injuries or significant bone or soft tissue loss.
Objective : Unusual or difficult management in non-union ulna
Methodology : Three paediatric cases of inadequately treated monteggia, post septic sequale which leads onto non-union
and multi directional instability of elbow & forearm presenting at Orthopaedics department, Institute of Child Health,
Egmore were selected for this study.
Results : In all 3 cases our study demonstrates management of non-union in ulna due to different etiology. In one case of
fracture non-union ulna with implant insitu and radial head dislocation, we have managed this case in 2 stages because
of difficult closure during fixation of ulna. In Stage 1 we have done ulna fixation and in stage 2 plating Shortening of
radius Recreating the ulnar angulation with corrective osteotomy ,temporary Radio capitellar k wire .In other two cases of
non-union ulna with elbow instability, radial head dislocation we have done single bone forearm to give elbow stability.
Functional outcome was assessed and found satisfactory. Safe and salvageable procedure is Single bone forearm in
forearm with significant bone loss.
Conclusion : We have achieved union of ulna and stable elbow and forearm .In single bone forearm surgery when
reconstruction not possible, the disadvantage of restricted supination and pronation movements which can be
compensated by shoulder movements. This procedure warrants good range of motion with normal daily activities.