Refractures of the Upper Extremity in Children

Abstract

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.

Removal of forearm plate leads to a high risk of refracture: decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture

“…The refracture rate of forearm fractures after implant removal ranges from 0.5 to 25 % in the literature [2,4,5,9,10]. In our investigation, the total refracture rate was approximately 12.9 % in the implant-removed group.…”

Paediatric forearm refractures- management and outcome: a prospective study

“…The reasons for refractures are various and include incomplete immobilization, inadequate healing. 4 Treatment of refracture is a debated topic with various authors advocating different methods. There are no definitive guidelines for management of forearm refracture and implant removal in paediatric cases.…”

Morphological features of bone regeneration in simulated refracture of growing long bones

“…Some researchers suggest that longer time period is required for reliable bone healing after refracture 17]. Although refractures are more common in the first 10 months refractures that occur 18 months after injury are more problematic [18,19]. Our findings indicated to delayed reparative processes and longer period of organotypical restructuring of the regenerate bone forming in interfragmental diastasis of long bones after refracture.…”