Nonoperatively treated forearm shaft fractures in children show good long-term recovery

Abstract

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.

Severe Trampoline Injuries: Incidence and Risk Factors in Children and Adolescents

“…This information was studied because of previous reports of children jumping with pets or heavy toys. 9 Nine out of 11 (82%) trampolines were the large or medium-sized ones. Larger trampolines produce more kinetic energy than the smaller ones and enable multiple children to jump at the same time.…”

“…Trampoline injuries contribute to the prevalence of permanent neurological sequelae in children and they change the pattern of pediatric trauma 8 : The incidence of severe forearm shaft fractures has increased fourfold during the 20th century, mostly because of trampoline injuries. 9 Many different trampoline injuries have been described, such as internal organ injuries, anal sphincter ruptures, vertebral arterial dissection, and permanent or long-lasting nerve lesions in the extremities. [10][11][12] While severe injuries are rare in trampoline jumping, minor injuries often occur.…”

“…4,5 They are usually benign injuries that do not require hospital treatment. 9 In general, pediatric injuries requiring professional treatment are most commonly fractures 13 and their incidence has increased approximately 15% during the last decades. [14][15][16] The majority of all fractures occur in upper extremities: in the forearm (45%) and upper arm (35%).…”

Both-Bone Forearm Fractures in Children with Minimum Four Years of Growth Remaining: Can Cast Achieve a Good Outcome at Skeletal Maturity?

“…This data was further supported by Hogstrom et al 14 , and Morrey et al 19 , who described that with the limitation of 60 degrees or less in the range of pronation and supination, patients seemed to be unaware of their incapacity due to good compensation by shoulder motion. Sinikumpu et al 20 , reviewed 47 nonoperatively treated both-bone forearm shaft fractures in children and found that the prono-supination of the forearm was not decreased in the long term, the grip strength was also equally as good as in the controls and the patients were satisfied with the outcome. In our study, the worst forearm rotation observed after skeletal maturity was 20 degrees far less than above studies.…”

Use of ketamine sedation for the management of displaced paediatric forearm fractures

“…They are the most common childhood fracture presenting to the paediatric emergency department (ED), with population studies suggesting that the incidence is on the rise throughout the world[ 3 , 4 ]. The majority are treated in the ED with closed reduction and immobilisation in a cast or a splint[ 5 , 6 ]. An arc of rotation of 100 degrees, split evenly between pronation and supination is accepted as normal[ 7 ].…”