Pediatric Forearm Fractures: Spotting and Managing the Bad Actors

Zlotolow, Dan A.

doi:10.1016/j.jhsa.2011.10.032

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…Physiotherapy has not traditionally been used for this purpose after treatment, but recent evidence suggests the benefits of physiotherapy in treating the contractures resulting in limitation of range of motion [57]. Some authors recommend a late follow-up visit to ensure that satisfactory range of motion of 0°-100°i s achieved [58].…”

Section: Other Treatmentmentioning

confidence: 99%

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The shaft fractures of the radius and ulna in children

Sinikumpu

Serlo

2015

Journal of Pediatric Orthopaedics B

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The incidence of forearm shaft fractures in children has increased in recent years. They are challenging to treat and they can result in several long-lasting complications. The treatment of children's fractures needs to be individualized to their needs. Nonoperative care will be satisfactory for young, preschool children and it is primarily treatment in stable fractures of children at every age. Injury mechanism must be understood to perform appropriate closed reduction. Immobilization using a long-arm cast needs to be focused against the deforming muscle forces - in particular those that rotate - in the forearm, keeping the bones in alignment until bone healing. Operative stabilization by elastic stable intramedullary nailing is the primarily method of treatment in cases of unstable fractures, in particular, in children between preschool age and adolescence. For older children near to skeletal maturity, a rigid plate and screw fixation will be justified. The most common complication after closed treatment is worsening of the alignment and need for repetitive interventions. elastic stable intramedullary nailing results usually in good outcome, and range of forearm rotation is the main feature determining the clinical result. In this article, we report the current concept of paediatric shaft fractures in the radius and ulna.

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Section: Other Treatmentmentioning

confidence: 99%

“…Compartment syndrome is a rare complication, the risk of which increases with multiple attempts at closed reduction and prolonged operation time [58,67]. Vascular damages are rare.…”

Section: Complications and Outcomementioning

confidence: 99%

The shaft fractures of the radius and ulna in children

Sinikumpu

Serlo

2015

Journal of Pediatric Orthopaedics B

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“…Closed reduction has traditionally been considered a satisfactory treatment in most cases of forearm shaft fracture ( Price 2010 ). There is little consensus concerning the amount of deformity as an indication for surgery ( Annan and Moran 2006 , Zlotolow 2012 ). However, the use of surgery has increased by 60% in recent years ( Cheng et al 1999 , Helenius et al 2009 ).…”

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confidence: 99%

Nonoperatively treated forearm shaft fractures in children show good long-term recovery

et al. 2014

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Background and purpose — The incidence of forearm shaft fractures in children has increased and operative treatment has increased compared with nonoperative treatment in recent years. We analyzed the long-term results of nonoperative treatment.Patients and methods — We performed a population-based age- and sex-matched case-control study in Vaasa Central Hospital, concerning fractures treated in the period 1995–1999. There were 47 nonoperatively treated both-bone forearm shaft fractures, and the patients all participated in the study. 1 healthy control per case was randomly selected and evaluated for comparison. We analyzed clinical and radiographic outcomes of all fractures at a mean of 11 (9–14) years after the trauma.Results — The main outcome, pronosupination of the forearm, was not decreased in the long term. Grip strength was also equally as good as in the controls. Wrist mobility was similar in flexion (85°) and extension (83°) compared to the contralateral side. The patients were satisfied with the outcome, and pain-free. Radiographally, 4 cases had radio-carpal joint degeneration and 4 had a local bone deformity.Interpretation — The long-term outcome of nonoperatively treated both-bone forearm shaft fractures in children was excellent.

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“…At the final follow-up, the majority of patients had a full 90/90 (pronation-supination) range of motion. In both bone fractures of the forearm, residual angulation can lead to disruption of joint movement [12]. In five of the patients, pronation and/or supination deficits were recorded at the final follow-up.…”

Section: Resultsmentioning

confidence: 96%

Retrograde Fixation of the Ulna in Pediatric Forearm Fractures Treated With Elastic Stable Intramedullary Nailing

Papamerkouriou

Christodoulou

Krallis

et al. 2020

Cureus

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This study analyzes the outcomes of retrograde fixation of the ulna in pediatric forearm fractures treated with elastic stable intramedullary nailing (ESIN). Materials and Methods A retrospective analysis was conducted by reviewing patient records of forearm fractures treated with ESIN by retrograde fixation. The study included 30 children (26 boys and 4 girls). The mean age at the time of injury was 11.7 years (range: 6.6 to 14.3 years). The technique is described. All patients were followed up until hardware removal. Results The mean time for fracture healing was 5.3 weeks (range: 4 to 8.8 weeks). The mean time for nail removal was 6.6 months (range: 5 to 10 months). There were five cases with rotation deficits, one of which was a re-fracture. Conclusions When antegrade nailing is performed, the ulna is sometimes complicated by non-union as well as entry point irritation. We did not encounter such complications. Retrograde fixation of the ulna in pediatric forearm fractures treated with ESIN is a safe and effective alternative to common fixation (antegrade ulnar fixation) and offers technical advantages.

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Pediatric Forearm Fractures: Spotting and Managing the Bad Actors

Cited by 10 publications

References 33 publications

The shaft fractures of the radius and ulna in children

The shaft fractures of the radius and ulna in children

Nonoperatively treated forearm shaft fractures in children show good long-term recovery

Retrograde Fixation of the Ulna in Pediatric Forearm Fractures Treated With Elastic Stable Intramedullary Nailing

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