In he age of 10-12 years in girls and 12-14 years in boys the surgical treatment must be strongly considered for displaced fractures of the forearm. Children aged 10 years or older with proximal-third radius fractures and ulna angulation less than 15º seem to be at highest risk for failure when treated nonoperatively for both-bone forearm fractures.

When both bones of the forearm are fractured, they are both exposed and provisionally reduced before fixation of either bone is completed. The fracture with the least comminution (usually the ulna) is fixed first. After reduction and provisional fixation of both bones, pronation and supination are examined; if normal, definitive fixation is performed. The general rule is that bone grafting is recommended when more than one third of the circumference of the bone is comminuted^[1][2].

The common therapeutic options in orthopedic medicine for ulnar fractures are^{[3][4][5][6][7]}:

• Open reduction and internal fixation with plates and screws

Known as the most common type of surgical repair for forearm fractures.

• Open reduction and internal fixation with rods
• External fixation

The indications for intramedullary nailing are :

• Segmental fractures
• Poor skin condition
• Selected nonunions or failed compression platings
• Multiple injuries
• Diaphyseal fractures in osteopenic patients