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Which factors affect limitation of pronation/supination after forearm fractures in children? A prospective

Joost W Colaris1, Jan Hein Allema2, Max Reijman1

  • 1Department of Orthopaedic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.

Injury
|November 5, 2013
PubMed

Insights

Re-fractures and diaphyseal fractures in children significantly increase the risk of limited forearm rotation after a both-bone fracture. More physiotherapy is linked to better outcomes in severe cases.

Area of Science:

  • Pediatric Orthopedics
  • Traumatology
  • Rehabilitation Medicine

Background:

  • Both-bone forearm fractures in children commonly lead to restricted pronation/supination, impacting daily activities.
  • Identifying factors associated with this limitation is crucial for effective management and improved functional outcomes.

Purpose of the Study:

  • To prospectively investigate clinical factors related to pronation/supination limitation in pediatric both-bone forearm fractures.
  • To determine the independent predictors of significant rotational deficit post-fracture.

Main Methods:

  • Prospective multicenter study including children (<16 years) with both-bone forearm fractures.
  • Data collected via questionnaires, physical examination, and X-rays over 6-9 months follow-up.
  • Univariate and multivariate logistic regression analyses used to identify associated clinical factors.

Main Results:

  • A re-fracture (OR 11.7) and diaphyseal fractures (OR 3.3) were independently associated with a pronation/supination limitation of ≥20°.
  • Less physiotherapy during follow-up was also linked to increased limitation (OR 0.90).
  • Study included 410 children with a 97.6% follow-up rate.

Conclusions:

  • Re-fractures and diaphyseal fractures are independent risk factors for limited forearm rotation in children.
  • Extensive physiotherapy is associated with better functional outcomes in children experiencing severe pronation/supination limitations.
Abstract

Keywords:
ChildrenForearm fracturesLimitation of pronation/supination

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