Segmental forearm bone injuries in children: classification and treatment

Abstract

BackgroundFractures of the forearm bones in children are a very frequent injury, while segmental injuries of the forearm bones are very rare and have not been sufficiently examined. In this retrospective study, segmental injuries involving the radius, the ulna or both in children are classified and treatment outcome is presented.Materials and methodsBone injury included any type of fracture or dislocation; segmental bone injury indicated the occurrence of more than one traumatic injury throughout the whole extent of each forearm bone. A total of 17 patients with 22 segmental bone injuries were identified and classified. Of these injuries, 12 involved the radius and 10 the ulna. The mean age at the time of injury was 8.9 years (range 3–13). In all cases, conservative treatment was the first treatment option; in three cases, however, surgical treatment was necessary.ResultsAll injuries were classified into five types using the new nomenclature. Patients were evaluated after an average follow-up of 10.4 years. Union was noted in all cases without any complications. The function results were rated as excellent in 15 cases and satisfactory in 2 cases.ConclusionsAn inclusive classification system for segmental injuries of the forearm bones in children is presented. The proposed classification is a practical and utilitarian scheme that classified the patients of this report as well as all case reports previously published in the literature. It revealed that a wide variety of segmental injuries may be diagnosed following forearm injuries in children. This report also provided useful information that may influence the treatment of these complex injuries indicating that conservative treatment may be considered the first treatment option, and that primary surgical treatment is not justified.Level of evidenceLevel V.

Perfil de crianças submetidas ao tratamento de fratura de antebraço

“…It was found that the results of this study showed that 61.54% of occurrences occur during leisure activities, since it is in accordance with the publications found where the majority of fractures occurred during leisure activities, almost that exclusively by accidental falls, 14 being falling during sports 2,7,16 or fall of height. 6,17, It was found, in a study carried out in Nigeria, that the main cause of fracture was different from that found in this study; of the 86 fractures studied, more than half (52.4%) occurred due to traffic accidents, including cars, motorcycles and tricycles, followed by falls in height (40.0%).…”