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Factors affecting remanipulation in paediatric forearm fractures
Puneet Monga1, Anantakrishna Raghupathy, Nigel H Courtman
1Furness General Hospital, Barrow-in-Furness, Cumbria, UK. puneetmonga05@gmail.com
Journal of Pediatric Orthopedics. Part B
|November 13, 2009
Summary
Children
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Surgical Innovation
Background:
- Forearm fractures in children treated with closed reduction and casting are prone to displacement.
- Redisplacement necessitates further intervention, impacting patient outcomes and healthcare resources.
Purpose of the Study:
- To identify predictors of post-reduction displacement in pediatric forearm fractures.
- To inform treatment strategies for reducing remanipulation rates.
Main Methods:
- Retrospective review of 114 pediatric radius and ulna fractures treated with closed reduction and casting.
- Analysis of preoperative and intraoperative factors influencing fracture redisplacement.
Main Results:
- The overall remanipulation rate was 14.04%.
- Preoperative translation deformity (P<0.0001) and residual intraoperative deformity (P=0.001) were significant predictors of redisplacement.
- Cast type, cast index, fracture pattern, fracture site, and surgeon grade did not significantly influence remanipulation rates.
Conclusions:
- Children's forearm fractures with preoperative translation deformity and incomplete anatomical reduction are at high risk for redisplacement.
- Internal fixation should be considered for these specific fracture patterns to improve outcomes and avoid remanipulation.
