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Longitudinal growth after nonphyseal forearm fractures
Belen Carsi1, Juan C Abril, Tomas Epeldegui
1Hospital del Nino Jesus, Madrid, Spain. belen.carsi@nth.northy.nhs.uk
Journal of Pediatric Orthopedics
|February 27, 2003
Summary
Forearm fractures in adults can lead to limb length discrepancies, with overgrowth being more common than previously thought. Radial fractures, particularly in the proximal and middle thirds, are associated with this overgrowth phenomenon.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Orthopedics
Background:
- Limb length discrepancy after fracture is a concern in orthopedic surgery.
- Overgrowth of the ulna or radius following forearm fractures is considered rare in adults.
Purpose of the Study:
- To investigate the incidence and characteristics of overgrowth after conservative treatment of adult forearm fractures.
- To identify factors associated with radial and ulnar overgrowth in forearm fractures.
Main Methods:
- A retrospective analysis of 119 adult patients with conservatively treated forearm fractures.
- Scanograms of both forearms were obtained 5 years post-fracture to assess length discrepancy.
- Overgrowth was defined as a length difference greater than 2 mm.
Main Results:
- Radial length discrepancy was observed in 67.2% and overgrowth in 26.8% of patients.
- Ulnar length discrepancy was observed in 54.6% and overgrowth in 24.3% of patients.
- Radial and ulnar overgrowth were associated with the fracture location (proximal/middle thirds) and handedness, but not with fracture type, age, sex, or associated ulnar fractures.
Conclusions:
- Overgrowth is a notable phenomenon after conservative treatment of adult forearm fractures, contrary to previous assumptions of rarity.
- Fracture location within the proximal and middle thirds of the radius is a significant predictor of overgrowth.
- Limb length discrepancy and overgrowth following forearm fractures require careful monitoring, with specific attention to fracture site and patient handedness.