Systematic Review on the Functional Outcome After Treatment of a Traumatic Bowing Fracture of the Lower Arm in Children

Abstract

Introduction Traumatic bowing is a commonly missed diagnosis on which only little information is available, inadequate treatment can cause permanent function loss. Method A systematic review would determine what the effect is of treatment of traumatic bowing of the lower arm in children on the functional outcome. A search on Embase, Medline, Web of Science, Scopus, Cochrane, Pubmed publisher, CINAHL and Google scholar, last accessed at the 15th of May 2016. Intervention of interest was treatment; with reduction, reduction and cast or cast only. The primary outcome measure was (I) function; pro and supination, (II) posttraumatic function, (III) posttreatment function and (IV) residual bowing. Results Five articles were included. Treatment by reduction only showed a normal function, 4 weeks to 8 weeks of cast and reduction followed by cast, both resulted in 0 degrees to 20 degrees residual of pronation loss. Discussion The treatment was overall well tolerated, had a direct effect and lead to faster restore of function. It is unclear to what amount of bowing can be accepted without any loss of function. But in view of the few complications and good results for reduction, the overall opinion is to reduce all significant bowing fractures of the lower arm in children with limited function.

Bilateral Asymmetry of the Forearm Bones as Possible Evidence of Antemortem Trauma in the StW 573 Australopithecus Skeleton from Sterkfontein Member 2 (South Africa)

“…Though rare, adult cases of TBF of the forearm bones have been documented and usually result from slow bending forces such as those caused by entrapment in rotating machines (e.g., Greene 1982;Simonian and Hanel 1996;Sclamberg et al 1998;Sen et al, 2004;Lefaivre et al 2007;Tada et al, 2008;Tianhao et al, 2014). However, most often, it is children between the ages of four and ten years that experience TBF (Vorlat and De Boeck 2003) as a result of falls onto outstretched, hyperextended hands (e.g., Borden 1974Borden , 1975Naga and Broadrick 1977;Crowe and Swischuk 1977;Aponte and Ghiatas 1989;Vorlat and De Boeck 2003;Musters and Colaris 2017). Descriptions of TBF in children vary in their level of detail, but it appears as though most falls that result in bowing are from rather insignificant heights and are, at least sometimes, associated with varying degrees of momentum.…”