Related Experiment Video
Updated: Feb 23, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
The emerging trend of non-operative treatment in paediatric type I open forearm fractures
H Zhang1, M Fanelli1, C Adams2
1Geisinger Health System, Department of Orthopaedics, Danville, PA 17822, USA.
Insights
Non-operative management of paediatric Type I open forearm fractures with antibiotics resulted in a 0% infection rate. This contrasts with the 1.9% infection rate seen in operative management, supporting a trend towards conservative treatment.
Area of Science:
- Orthopaedic Surgery
- Paediatric Orthopaedics
- Trauma Management
Background:
- Open fractures are orthopaedic emergencies requiring operative debridement.
- Recent evidence questions operative management for paediatric Gustilo-Anderson Type I open fractures.
Purpose of the Study:
- To evaluate the non-operative management of Type I open paediatric forearm fractures.
- To determine the infection risk associated with non-operative treatment in this population.
Main Methods:
- A meta-analysis of five studies involving paediatric patients with Type I open forearm fractures treated non-operatively.
- Literature search conducted using Ovid MEDLINE and PubMed databases.
- Pooled infection risk calculated using a fixed-effect model with 95% confidence intervals.
Main Results:
- A total of 127 paediatric patients were included across the five studies.
- All patients received antibiotic treatment; none underwent operative debridement.
- The pooled infection rate was 0% (95% CI 0 to 2.9%).
Conclusions:
- Non-operative management of Type I open paediatric forearm fractures is associated with a 0% infection rate.
- This finding supports the trend towards conservative treatment for these injuries.
- The infection rate for operatively managed Type I fractures is 1.9%.
Purpose:
Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures.
Methods:
An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention. A fixed-effect meta-analysis, weighting each study based on the number of patients, and a pooled estimate of infection risk (with 95% confidence interval (CI)) was performed.
Results:
The search results yielded five studies that were eligible for inclusion. No included patients had operative debridement and all were treated with antibiotics. The number of patients in each study ranged from 3 to 45, with a total of 127 paediatric patients in the meta-analysis. The infection rate was 0% for all patients included. The meta-analysis estimated a pooled infection risk of 0% (95% CI 0 to 2.9).
Conclusions:
The five included studies had a total of 127 patients with no cases of infection after non-operative management of Type I open paediatric forearm fractures. The infection rate of Type I fractures among operatively managed patients is 1.9%. The trend in literature towards non-operative treatment of paediatric Type I open fractures holds true in this meta-analysis.
More Related Videos
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: