In adults, simultaneous fractures of the shaft of the ulna and radius (the so-called "both bone fractures") are most often the consequence of a direct blow to the forearm or other high energy mechanisms. In the adult, these injuries usually require surgical fixation. By contrast, these injuries in the pediatric population result from simple falls and other lower energy mechanisms. In children, ulnar and radial shaft fractures are amenable to casting. Imperfect healing can lead to loss of pronation and supination of the hand.
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