Abstract
Introduction
Fractures of the forearm bones (radius and ulna) are common injuries in both children and adults and may result in functional limitations if inadequately managed. In low-resource settings such as Mushie, Democratic Republic of the Congo, limited information is available on their incidence, causes, and outcomes.
Purpose
This study aimed to describe the epidemiological characteristics, causes, management, and short-term outcomes of forearm fractures treated at Mushie General Referral Hospital in 2021.
Methods
We conducted a retrospective descriptive study including all patients admitted for a fracture of the radius and/or ulna between 1 January and 31 December 2021. Data collected from medical records included age, sex, fractured bone, affected side, fracture type, mechanism of injury, treatment modality, duration of treatment, and early outcomes (union, nonunion, malunion). Proportions were reported with 95% confidence intervals using Wilson’s method. Chi-square and binomial tests were applied to compare proportions.
Results
A total of 44 forearm fractures were recorded, representing 3.4% of all surgical procedures (n = 1278) and 21.1% of all fractures (n = 208). Most patients were boys (63.6%), with the highest frequency in the 6–10-year age group. The radius alone was involved in 56.8% of cases, the ulna alone in 25.0%, and both bones in 18.2%. The left upper limb was affected in 63.6% of cases. Road traffic accidents were the leading cause (50.0%), followed by falls from trees and play-related injuries. Orthopaedic management was used in 75.0% of cases, with a union rate of 84.1%; nonunion and malunion occurred in 6.8% and 9.1% of cases, respectively.
Conclusion
Forearm fractures represent a significant proportion of traumatic injuries at this semi-rural hospital, predominantly affecting young boys. The high incidence of road traffic accidents underscores the need for targeted prevention strategies and improved trauma care capacity in similar low-resource settings.
References
Abdoul Wahab, A. M., Alzouma, A. A. A., Dalatou, M. M. M. H., Garba, I., & Badio, S. S. (2024). Fractures of the distal radius: Epidemiological and injury aspects in a study of 107 cases. Moroccan Journal of Orthopedic & Traumatological Surgery, 108, 34–40.
Al-Sadek, T. A., Niklev, D., & Al-Sadek, A. (2016). Diaphyseal fractures of the forearm in adults: Plating or intramedullary nailing is a better option for the treatment? Open Access Macedonian Journal of Medical Sciences, 4(4), 670–673. https://doi.org/10.3889/oamjms.2016.138
Bombah, F. M., Batchom, A. D., Davokdi, A., Mantho, P., Nyekel, R., Eone, D. H., … Ngowe Ngowe, M. (2023). Management of diaphyseal fractures of both forearm bones in two hospitals in Douala: Indications, techniques, and results. Health Research in Africa, 1(4, Suppl. 1). https://doi.org/10.5281/hra.v1i4(Suppl1).4966
Campagne, D. (2025). Fractures of the mid-forearm. University of California, San Francisco.
Cintean, R., Eickhoff, A., Zieger, J., Gebhard, F., & Schütze, K. (2023). Epidemiology, patterns, and mechanisms of pediatric trauma: A review of 12,508 patients. European Journal of Trauma and Emergency Surgery, 49(1), 451–459. https://doi.org/10.1007/s00068-022-02088-6
Chung, K. C., & Spilson, S. V. (2001). The frequency and epidemiology of hand and forearm fractures in the United States. Journal of Hand Surgery (American Volume), 26(5), 908–915.
Cosman, F., de Beur, S. J., LeBoff, M. S., Lewiecki, E. M., Tanner, B., Randall, S., & Lindsay, R. (2014). Clinician's guide to prevention and treatment of osteoporosis. Osteoporosis International, 25(10), 2359–2381. https://doi.org/10.1007/s00198-014-2794-2
Da Costa, A. P., Rodrigues, E. T., Hauache, H. A., Fujisaki, M. A., & Dobashi, E. T. (2025). Comparative analysis of treatments for forearm fractures in children: A systematic review and meta-analysis. Acta Ortopedica Brazil, 33(6), e290231. https://doi.org/10.1590/1413-785220253306e290231
Gutzeit, E. M., et al. (2021). Epidemiological study of forearm fractures in an emergency room in Rondônia. Research, Society and Development, 10(17), e165101724622. https://doi.org/10.33448/rsd-v10i17.24622
Hamidi, D., Sharma, O., Bozzo, I., Alrajhi, K., & Bernstein, M. (2025). Conservative versus surgical treatment of pediatric both-bone forearm fractures: A systematic review and meta-analysis. McGill Science Undergraduate Research Journal, 20(2). https://doi.org/10.26443/msurj.v1i2.309
Karatas, M. E., Kılıç, N. C., Eceviz, E., & Altun, G. (2025). Plate or intramedullary fixation: A comparative analysis of surgical treatment options for adult both-bone forearm fracture – A retrospective clinical study. Ulus Travma Acil Cerrahi Derg, 31(10), 1018–1025. https://doi.org/10.14744/tjtes.2025.73928
Klein, C. (2025). Management of pediatric forearm fractures in 2025. Revue de Chirurgie Orthopédique et Traumatologique, 111(6), 537–545. https://doi.org/10.1016/j.rcot.2025.04.007
Kronk, T. A., Steiner, R. P., Ritzman, T. F., & Floccari, L. V. (2025). Surgical treatment of pediatric open forearm fractures: A comparison of outcomes with or without internal fixation. Journal of Pediatric Orthopedics. Advance online publication. https://doi.org/10.1097/BPO.0000000000003159
Mallmin, H., & Ljunghall, S. (1992). Incidence of Colles’ fracture in Uppsala: A prospective study of a quarter-million population. Acta Orthopaedica Scandinavica, 63(2), 213–215. https://doi.org/10.3109/17453679209154826
Nellans, K. W., Kowalski, E., & Chung, K. C. (2012). The epidemiology of distal radius fractures. Hand Clinics, 28(2), 113–125. https://doi.org/10.1016/j.hcl.2012.02.001
RA, A. M., YRD, N. B., Diawara, R. K., … AOJJ. (2022). Surgical treatment of forearm fractures in children at Owendo University Hospital: A study of 42 cases. Health Sciences and Disease, 23(2). https://doi.org/10.5281/hsd.v23i2.3347
Ryan, L. M., Teach, S. J., Searcy, K., Singer, S. A., Wood, R., Wright, J. L., & Chamberlain, J. M. (2010). Epidemiology of pediatric forearm fractures in Washington, DC. The Journal of Trauma, 69(4, Suppl.), S200–S205. https://doi.org/10.1097/TA.0b013e3181f1e837
Towoezim, H., Tamegnon, D., Dellanh, Y. Y., Fare, G.-P., Ayouba, G., Batarabadja, B., & Abalo, A. (2023). Clinical aspects and surgical indications for diaphyseal fractures of the forearm bones in adults at the Kara University Hospital Center. European Scientific Journal, 19(30), 109. https://doi.org/10.19044/esj.2023.v19n30p109
Viberg, B., Tofte, S., Rønnegaard, A. B., Jensen, S. S., Karimi, D., & Gundtoft, P. H. (2023). Changes in the incidence and treatment of distal radius fractures in adults: A 22-year national register study of 276,145 fractures. Injury, 54(7), 110802. https://doi.org/10.1016/j.injury.2023.05.033
Wang, W. T., & Chen, C. S. (2024). Treatment of the distal forearm fracture by volar dual window approach. Life, 14(8), 972. https://doi.org/10.3390/life14080972
Wilson, F. C., Dirschl, D. R., & Bynum, D. K. (1997). Adult forearm fractures: An outcome analysis of factors influencing results. The Iowa Orthopedic Journal, 17, 14–19.

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