Treatment of Distal Forearm Fractures in Children
J-J Sinikumpu1, Y Nietosvaara2,3
1Unit of Pediatric Surgery and Orthopedics, Oulu University Hospital, and, PEDEGO Research Unit and MRC Oulu, Oulu Childhood Trauma and Sports Injury Study, University of Oulu, Oulu, Finland.
Background And Aims:
Distal forearm is the most common fracture location in the growing skeleton. The aim of this article is to describe the current practice of these fractures.
Materials And Methods:
Case series accompanied by experts' opinion.
Results And Conclusion:
Most of these injuries are benign incomplete distal metaphyseal torus fractures best treated with a dorsal below elbow splint for 2-3 weeks with no follow-up. Completely displaced metaphyseal fractures in prepubertal children can be either immobilized in bayonet position after axial alignment or fixed with K-wires after reduction. Complete fractures of distal metaphysis in adolescents should heal in near anatomic alignment because remodeling is uncertain. We advocate reduction of most greenstick and complete fractures at the distal metaphyseal diaphyseal junction and radiographic follow-up to monitor fracture alignment. Physeal fractures in adolescents and intra-articular fractures in children of all ages should be anatomically reduced. We perform most of our osteosyntheses with K-wires.
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