[Late results of forearm fractures in childhood]

At the Department of Pediatric Surgery, University of Munich, 1143 children up to 14 years of age were treated for forearm fractures between 1976 and 1985. Two-thirds of distal metaphyseal fractures affect only the radius, but diaphyseal fractures involve both bones in two-thirds to three-quarters of cases. In 97.8% of the cases, conservative therapy was administered. Follow-up examination was performed 3-13.5 years after treatment in 144 patients (including all with complications resulting from the fracture itself, the therapy or the healing). There were 32 who reported functional restriction, and 20 had reduced mobility of the wrist, most in supination/pronation. Very good and good results were found in 79.2%, satisfactory results in 13.9%, and unsatisfactory results in 6.9%. Meta- and diaphyseal fractures of both bones required 57% of all secondary reductions and 76.9% of a secondary operations. This applies to 70% of cases with more than 10 degrees deviation of axis at the end of treatment and most cases with severe functional restrictions later. In these cases more frequent operative management seems to be necessary to improve overall results.