<p><strong>Aim</strong> <br />Distal radius/forearm fractures in adolescent patients remain challenging injuries to treat. Distal radius/forearm bony anatomy is not completely restored with intramedullary K wire fixation. The aim of this study was to compare radiographic and functional outcomes obtained using intramedullary K wire fixation and open reduction and internal fixation in the treatment of distal radius/forearm fracture.<br /><strong>Methods<br /></strong> A total of 43 patients who presented with distal radius/forearm fractures were enrolled and divided into two groups: 23<br />patients treated with K-wire (IMNK) and 20 patients treated with plate and screws (ORIF). The evaluation criteria were: fracture healing time, objective quality of life measured by the Mayo wrist score (MWS) and quick disabilities of the arm, shoulder and hand score (QuickDash), length time of surgery, complications, sport or play return, forearm visual analogic pain (FVAS), bone healing by radius union scoring system (RUSS).<br /><strong>Results</strong> <br />In both groups the results obtained were comparable in terms of functional, pain and return to play/sport after the third<br />month after surgery. Bone healing was faster in IMNK than ORIF but without significance (p>0.05). There was less complication in ORIF than IMNK (p<0.05).<br /><strong>Conclusion</strong> <br />The treatment of adolescent distal radius or forearm fractures remains challenging. One challenge facing the physician<br />is the choice of surgical technique and fixation method, which will be influenced by individual experience and preference.<br />The question of distal radius or forearm fractures in adolescents would be best answered with a prospective randomized study.</p>

Objective. To present the clinical and functional results of medial epicondylar fractures in 24 surgically-treated children with long-term follow-up. Methods. We retrospectively reviewed 24 cases of displaced medial epicondylar fracture surgically treated between January 2013 and December 2016. Demographical characteristics of patients were recorded and analyzed along with radiographical images. Patients underwent clinical evaluation and were asked to answer to the Quick DASH test to assess long term functional outcome. Results. Mean follow-up was 4.8 years. Complete range of movement of the elbow was restored in all cases except for 4 cases of extension lag inferior to 30° and 2 cases of slightly reduced pronation. Valgus deformity of the elbow inferior to 15° was observed in 3 patients. Mean Quick DASH score was 15.1. Conclusions. Even if the treatment guidelines of displaced medial epicondyle fractures are still debated, our study demonstrates satisfying functional results in the long term after surgical treatment, without major complications. In addition, surgery allows anatomic reduction of the fracture, preventing fibrous nonunion.

Purpose: To analyse clinical case of neonatal bilateral humerus fractures, which represent a very rare event in births by caesarean section. Method: We analysed the case of a newborn with a bilateral humerus fractures associated with a caesarean delivery in the Paediatric Intensive Care Unit of our centre. The infant was delivered premature at seven and a half months, weighed 1,100g, was 33.4 cm in length and was born by caesarean section performed on a primiparous mother in non-urgent conditions. The extraction of the newborn was hampered by the entrapment of the head. The new-born's family history was negative for cases of osteogenesis imperfecta or other osteo-metabolic genetic diseases. The treatment adopted was a partial reduction and immobilization under sedation. The radiographic follow-up performed at 4 weeks showed a bone remodelling with good alignment of the axis. From a clinical point of view, the newborn had neither deficits nor residual deformities. Results: The main risk factors are: prematurity, low birth weight, foetal malposition, uterine defects, first pregnancy, delivery in conditions of emergency and iatrogenic birth traumas. In these cases, it is important to exclude the possibility of pathologies of an osseous or chromosomal nature. Conclusion: It is essential to immediately dispel any doubts regarding the possibility of osseous or chromosomal disorders. The careful management of the medical-parent relationship is important in order to best handle parental anxiety and avoid the potential risk of unnecessary medical disputes.

No abstract