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Nonoperatively treated forearm shaft fractures in children show good long-term recovery
Juha-Jaakko Sinikumpu1, Sarita Victorzon, Eeva Antila
1Division of Paediatric Surgery and Orthopaedics , Oulu University Hospital, and Medical Research Center Oulu, Oulu University , Oulu.
Insights
Nonoperative treatment for pediatric forearm shaft fractures yields excellent long-term results, with no loss in forearm function or grip strength. Patients reported satisfaction and remained pain-free.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Clinical Outcomes Research
Background:
- Forearm shaft fractures in children are increasing.
- Operative treatment rates have risen, prompting re-evaluation of nonoperative methods.
Purpose of the Study:
- To analyze the long-term clinical and radiographic outcomes of nonoperatively treated pediatric both-bone forearm shaft fractures.
Main Methods:
- Population-based, age- and sex-matched case-control study.
- 47 nonoperatively treated patients (1995-1999) compared with 47 healthy controls.
- Long-term follow-up (mean 11 years) assessing function and radiographic changes.
Main Results:
- Excellent long-term pronosupination and grip strength, comparable to controls.
- No significant decrease in wrist mobility (flexion/extension).
- Radiographic findings included minor radio-carpal degeneration or local bone deformity in a small subset.
Conclusions:
- Nonoperative management of pediatric both-bone forearm shaft fractures demonstrates excellent long-term functional outcomes.
- High patient satisfaction and pain-free status reported.
- This approach is a viable and effective treatment option for these injuries.
Background And Purpose:
The incidence of forearm shaft fractures in children has increased and operative treatment has increased compared with nonoperative treatment in recent years. We analyzed the long-term results of nonoperative treatment.
Patients And Methods:
We performed a population-based age- and sex-matched case-control study in Vaasa Central Hospital, concerning fractures treated in the period 1995-1999. There were 47 nonoperatively treated both-bone forearm shaft fractures, and the patients all participated in the study. 1 healthy control per case was randomly selected and evaluated for comparison. We analyzed clinical and radiographic outcomes of all fractures at a mean of 11 (9-14) years after the trauma.
Results:
The main outcome, pronosupination of the forearm, was not decreased in the long term. Grip strength was also equally as good as in the controls. Wrist mobility was similar in flexion (85°) and extension (83°) compared to the contralateral side. The patients were satisfied with the outcome, and pain-free. Radiographally, 4 cases had radio-carpal joint degeneration and 4 had a local bone deformity.
Interpretation:
The long-term outcome of nonoperatively treated both-bone forearm shaft fractures in children was excellent.
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