Clin Orthop Relat Res. 1988 Sep(234):2-4.
In the case of fractures of the middle one-third of the forearm that are several weeks old, the procedure is as follows. Use a brachial block or general anesthesia. Open the radial fracture by freeing up the fracture site and clearing the medullary canals. About a 4-cm longitudinal incision is made over the dorsal aspect of the radius at the wrist distant from the fracture and between the tendons of the extensor pollicis longus and the extensor carpi radialis longus and brevis. Make a hole in the radius with a small gouge with insertion of the pin to the fracture site and then drive it into the proximal fragment. Then cut the pin off at the right length and set it into the bone with hammer blows to the driver. Remove the driver. Check the reduction of the fracture and closure of the wound. Repeat the procedure on the ulna with the difference that the trephination of the ulna is done proximally. Apply the splint. The fracture site must be protected carefully to avoid angulation. Should this occur, it can be corrected without opening the fracture site because the pins are flexible. We have operated upon four isolated fractures of the ulna, one isolated fracture of the radius, and two fractures of both radius and ulna. I believe that the procedure is simple and practical to perform. Whether and to what extent a similar procedure can be carried out satisfactorily on other bones with larger marrow canals remains to be seen.