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Malunited forearm fractures in children
C T Price1, D S Scott, M E Kurzner
1Matthews Orthopaedic Clinic, Orlando, FL 32856.
Journal of Pediatric Orthopedics
|November 1, 1990
Summary
Closed reduction is effective for severe pediatric forearm fractures, yielding excellent functional and cosmetic results. Most patients experienced good or excellent outcomes, with distal fractures showing a better prognosis.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Severe diaphyseal both-bone forearm fractures in skeletally immature patients present treatment challenges.
- Previous management strategies and outcomes for this specific pediatric fracture type require further elucidation.
Purpose of the Study:
- To evaluate the long-term functional and cosmetic outcomes of closed reduction for severe diaphyseal forearm fractures in pediatric patients.
- To identify factors influencing recovery and treatment success in this population.
Main Methods:
- Retrospective review of 80 skeletally immature patients with severe diaphyseal forearm fractures treated between 1971 and 1986.
- Exclusion of Greenstick, Monteggia, and Galeazzi fractures; 79 fractures managed with closed reduction.
- Follow-up evaluation of 39 patients with malunions for at least 2 years post-injury.
Main Results:
- No delayed unions or nonunions observed in the entire cohort.
- High patient satisfaction with functional and cosmetic results, irrespective of initial fracture characteristics.
- 92% of patients achieved good or excellent outcomes; only 8% had fair results, with no poor outcomes.
Conclusions:
- Closed reduction is the preferred treatment for severe diaphyseal forearm fractures in skeletally immature patients.
- Functional and cosmetic results are generally favorable, with distal fractures having a better prognosis.
- Age at injury did not impact motion recovery, highlighting the efficacy of non-operative management.