Analyzing forearm fractures in children. The more subtle signs of impending problems

Poor results with pediatric forearm fractures, while infrequent, do occur. Systematic analysis is required to identify this relatively rare, evolving problem. The purpose of this retrospective study was to identify and organize factors that would help in this process. Sixty-nine patients aged one-17 years with displaced forearm fractures were identified retrospectively. Pre- and postreduction radiographs were analyzed in comparison to standards for displacement, angulation, bow, shortening, and rotation. Those patients who seemed most likely to have problems following treatment were recontacted. Even with the use of stringent criteria in a group weighted toward more severe fractures, 85% of the patients achieved satisfactory results. With careful analysis of fractures for changes in angulation, bow, and disruption of the proximal or distal radioulnar joints, these problems should be avoidable. Analysis relative to standard radiographs aids in the identification of subtle malalignments that would otherwise be easily overlooked.