Remodelling After Distal Forearm Fractures in Children II:<i>The Final Orientation of the Distal and Proximal Epiphyseal Plates of the Radius</i>

Friberg, K. S. I.

doi:10.3109/17453677908991303

Cited by 52 publications

(17 citation statements)

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“…The criteria for acceptable postreduction alignment and apposition were developed with use of commonly accepted guidelines [10][11][12][13][14][15][16][17] and by consensus of the group of six orthopaedic surgeons participating in the study. These same criteria were also used to guide treatment at the initial presentation of the child at the emergency department.…”

Section: Methodsmentioning

confidence: 99%

Above and Below-the-Elbow Plaster Casts for Distal Forearm Fractures in Children<sbt aid="1039044">A Randomized Controlled Trial</sbt>

Bohm

Bubbar

Hing

et al. 2006

J Bone Joint Surg Am

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Section: Methodsmentioning

confidence: 99%

Above and Below-the-Elbow Plaster Casts for Distal Forearm Fractures in Children<sbt aid="1039044">A Randomized Controlled Trial</sbt>

Bohm

Bubbar

Hing

et al. 2006

J Bone Joint Surg Am

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“…Part of this ambiguity stems from a lack of consensus about the remodeling potential of the distal radius. Friberg reported that fractures with over 20°of dorsal angulation may not remodel completely, but Hughston demonstrated that, in children under 10 years of age, the distal radius can remodel up to 30-40°of angulation in the sagittal plane [8,[19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Isolated distal radial metaphyseal fractures with an intact ulna: Risk factors for loss of reduction

Sankar

Beck

Brewer

et al. 2011

Journal of Children's Orthopaedics

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Purpose The purpose of this study was to determine the risk factors for loss of reduction in patients with an isolated distal radius fracture and intact ulna. Methods Outpatient records and initial, post-reduction, and follow-up radiographs of children with displaced distal radial metaphyseal fractures and intact ulnas that required closed reduction and casting at our institution were reviewed for demographic factors, body mass index (BMI), initial fracture displacement, residual displacement after reduction, and 3-point cast index. Loss of reduction was defined as angulation C15°in the coronal plane for all ages and/or angulation C20°in the sagittal plane for patients C11 years of age and C30°for children \11 years of age. Additionally, all patients who were remanipulated and/or pinned were considered to have lost reduction. Results Thirty-five of the 76 patients in our series met the criteria for loss of reduction (46%). Multivariate logistic regression revealed that initial angulation in the coronal plane and post-reduction translation in the coronal plane were independent predictors for loss of reduction. Patients with [11°of initial angulation in the coronal plane were 6.3 times as likely to lose reduction (confidence interval [CI]: 1.43-28.3, P = 0.015) and those with any amount of residual translation in the coronal plane after closed reduction were 7.8 times as likely to lose reduction (CI: 2.5-24.0, P \ 0.001). Conclusion Our study, the largest dedicated series of distal radial metaphyseal fractures with intact ulnas, indicates that loss of reduction is common, and that risk factors include initial angulation in the coronal plane and postreduction translation in the coronal plane.

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“…Despite this, clinical and radiographic follow-up examinations are frequently performed (Green et al 1998). The great remodeling potential in a child's distal radius allows dorsal angulation of up to 20° for good clinical and anatomical long-term results (Friberg 1979, Qairul et al 2001). …”

Section: Introductionmentioning

confidence: 99%

Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

Randsborg

Sivertsen

2009

Acta Orthopaedica

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Background and purpose Numerous follow-up visits for wrist fractures in children are performed without therapeutic consequences. We investigated the degree to which the follow-up visits reveal complications and lead to change in management. The stability of greenstick and buckle fractures of the distal radius was assessed by comparing the lateral angulation radiographically.Patients and methods The medical records of 305 distal radius fractures in patients aged less than 16 years treated at our institution in 2006 were reviewed, and any complications were noted. The fracture type was determined from the initial radiographs and the angulation on the lateral films was noted.Results Only 1 of 311 follow-ups led to an active intervention. The greenstick fractures had more complications than the buckle fractures. The lateral angulation of the buckle fractures did not change importantly throughout the treatment. The greenstick fractures displaced 5° on average, and continued to displace after the first 2 weeks. On average, the complete fractures displaced 9°.Conclusion Buckle fractures are stable and do not require follow-up. Greenstick fractures are unstable and continue to displace after 2 weeks. Complete fractures of the distal radius are uncommon in children, and highly unstable. A precise classification of fracture type at the time of diagnosis would identify a smaller subset of patients that require follow-up.

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Remodelling After Distal Forearm Fractures in Children II:The Final Orientation of the Distal and Proximal Epiphyseal Plates of the Radius

Cited by 52 publications

References 4 publications

Above and Below-the-Elbow Plaster Casts for Distal Forearm Fractures in Children<sbt aid="1039044">A Randomized Controlled Trial</sbt>

Above and Below-the-Elbow Plaster Casts for Distal Forearm Fractures in Children<sbt aid="1039044">A Randomized Controlled Trial</sbt>

Isolated distal radial metaphyseal fractures with an intact ulna: Risk factors for loss of reduction

Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

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