Refracture of the Forearm in Children

Schwarz, N.; Pienaar, Simon; Schwarz, Angelika; Jeleń, Michał; Styhler, W.; Mayr, Johannes

doi:10.1302/0301-620x.78b5.0780740

Cited by 58 publications

(38 citation statements)

References 3 publications

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“…8,9 The purpose of this study was to determine the risk factors for forearm refracture based on initial fracture severity, initial fracture location, residual fracture line visibility, and residual fracture malalignment. The risk factors leading to refracture in these studies included greenstick type fractures, residual fracture angulation, incomplete fracture healing, midshaft location, and a younger age.…”

mentioning

confidence: 99%

The Healing Forearm Fracture

Baitner

Perry²,

Lalonde³

et al. 2007

Journal of Pediatric Orthopaedics

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mentioning

confidence: 99%

The Healing Forearm Fracture

Baitner

Perry²,

Lalonde³

et al. 2007

Journal of Pediatric Orthopaedics

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“…Refractures occurred at areas of incomplete bony union within 5 months of the primary fracture. The so-called "greenstick fracture" has been known to be susceptible to refractures 8,10,14. Bony union on the convex side of the fracture that has a loss of cortex continuity is delayed due to the elasticity of the concave side, which maintains continuity of the cortex.…”

Section: Discussionmentioning

confidence: 99%

Refractures of the Upper Extremity in Children

et al. 2007

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PurposeTo investigate the etiologic factors related to refractures of the upper extremity in children.Patients and MethodsEighteen refractures were divided into three groups according to the location of the initial fractures. They were analyzed in terms of the type of refractures, fracture patterns, and the existence of an underlying deformity.ResultsOf nine supracondylar fractures of the humerus, two involved refractures at the supracondylar region, and the other seven involved the lateral condyle. Underlying cubitus varus was present in six cases. Of three lateral condylar fractures of the humerus, one had a refracture at the supracondylar region, and two cases involved the lateral condyle. One had an underlying cubitus varus. All but one case in the humeral fractures group were late refractures, and were treated with surgery. Of six repeat forearm fractures, five were early type and occurred at the original site within nine weeks, four at the diaphysis of both bones of the forearm, and one at the diaphysis of the ulna. All cases in the forearm fractures group, save one, had volar angulation before the refracture, and were treated conservatively.ConclusionIn the humerus, the underlying cubitus varus was the most important predisposing factor for refractures and lateral condyle fractures were common. In the forearm, volar angulation of the diaphysis was related to refractures, and complete and circular consolidation of the primary fracture of the forearm was thought to be important in prevention.

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“…In comparison to adults, there is a relatively low incidence re-fracture in children. Reports from the 1990s suggest only 5% of children who fracture their forearm will re-fracture within 18 months 8,9. Similarly, in a 2006 study, only 1 case of forearm re-fracture was observed at the same site in 125 female children with 58 fractures followed prospectively for 8 years, or a rate of 1.7% 10…”

Section: Introductionmentioning

confidence: 93%

Rapid Remineralization of the Distal Radius AfterForearmFracture in Children

Fung¹,

Humphrey²,

Gildengorin³

et al. 2011

Journal of Pediatric Orthopaedics

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Background Bone mineral content (BMC) and density (BMD) have been shown to diminish following fracture and immobilization in adults. Distal radius fractures (DRFx) are common in children, and unlike adults, there is a low incidence of re-fracture. The primary aim of this study was to assess the change in radial BMC and BMD following upper extremity fracture and casting in healthy pediatric patients. Methods Subjects were recruited at the time of DRFx casting. The non-fractured (non-Fx) distal radius was initially scanned by dual energy x-ray absorptiometry (baseline), and then both arms were scanned at the time of cast removal (CastOff), as well as 4, 8, 12, 24 and 52 weeks post cast removal. Results Twenty-one subjects were enrolled (13 Male, 13 Caucasian, 10.4±2.5 yrs) with an average length of casting of 38 ± 11 days. Eighteen subjects (86%) completed all protocol requirements. At CastOff, there was no significant difference in total BMC or BMD between the fractured and non-Fx arms. From CastOff to 24 weeks, the overall change in BMC and BMD for the non-Fx arm was +4.2% and +0.2%, respectively; while for the Fx arm, the change was +8.3% and +3.4%, respectively. By 24 weeks, the difference in the overall change in BMD between the Fx and non-Fx arms was statistically significant (greater than instrumental error and p<0.05). However, by 52 weeks, these differences were no longer significant. The increased mineralization was unrelated to age, gender, arm dominance or calcium intake. Conclusions This data shows that there is rapid re-mineralization following a simple forearm fracture in children, with a transient elevation in BMD in the fractured arm after casting. This novel finding suggests that bone may be stronger around the site of fracture and could significantly change how we counsel young patients recovering from forearm fracture. Future research should focus on children immobilized for varying lengths of time, as well as those with repeat fractures, employing volumetric techniques of bone geometry and strength assessment.

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Refracture of the Forearm in Children

Cited by 58 publications

References 3 publications

The Healing Forearm Fracture

The Healing Forearm Fracture

Refractures of the Upper Extremity in Children

Rapid Remineralization of the Distal Radius AfterForearmFracture in Children

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