The effects of maximal radial bowing on forearm rotation in pediatric diaphyseal forearm fractures

Wongcharoenwatana, Jidapa; Eamsobhana, Perajit; Chotigavanichaya, Chatupon; Ariyawatkul, Thanase; Kaewpornsawan, Kamolporn

doi:10.1007/s12306-021-00728-5

Cited by 1 publication

(2 citation statements)

References 19 publications

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“…They suggest that mean radial bowing should be restored to approximately 6–7% for optimal forearm rotation after fracture reduction. The location of the radial bowing shows no significant correlation with the amount of pro/supination limitation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a previous study showed that when cases are missing at random or completely at random, up to 60% loss to follow-up is acceptable, without influencing the outcome [ 25 ]. Other studies have suggested that up to 40% loss to follow-up results in minimal attrition of the results [ 11 ]. To expose any potential effects of attrition we undertook a representability analysis comparing the included and loss to follow-up groups, which showed the follow-up group was representative of the whole original study group (see Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

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Improved forearm rotation even after early conversion to below-elbow cast for non-reduced diaphyseal both-bones forearm fractures in children: a secondary 7.5-year follow up of a randomized trial

Musters,

Diederix,

Edomskis

et al. 2023

ActaO

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Background and purpose: previous RCT compared short-term results of above-elbow cast (AEC) with early conversion to below-elbow cast (BEC) in children with non-reduced diaphyseal both-bone forearm fractures. After 7 months both groups had comparable function. Our primary aim was to investigate whether forearm rotation improves or worsens over time. Secondary aims were loss of flexion and extension of the elbow and wrist, patient-reported outcomes measures, grip strength ratio, and radiographic assessment.Patients and methods: We performed long-term follow-up (FU) of a previous RCT. All patients were invited again for the long-term FU measurements. Primary outcome was limitation of forearm rotation. Secondary outcomes were loss of flexion and extension of the elbow and wrist compared with the contralateral forearm, the ABILHAND-Kids questionnaire and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, grip strength ratio, and radiographic assessment.Results: The mean FU was 7.5 (4.4–9.6) years. Of the initial 47 children, 38 (81%) participated. Rotation improved in both groups over time, with no significant difference in the final forearm rotation: 8° (SD 22) for the AEC group and 8° (SD 15) for the BEC group with a mean difference of 0° (95% confidence interval –13 to 12). Secondary outcomes showed no statistically significant differences. Finally, children < 9 years almost all have full recovery of function.Conclusion: Long-term follow-up showed that loss of forearm rotation after a non-reduced diaphyseal both-bone forearm fracture improved significantly compared with that at 7 months, independent of the initial treatment and children aged < 9 will have almost full recovery of function. This substantiates that the remaining growth behaves like a “friend” at long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%