Treatment of diaphyseal forearm fractures in children

doi:10.4081/or.2014.5325

Cited by 52 publications

(66 citation statements)

References 41 publications

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“…Finnish [23], American [15], and Japanese [11] studies reported an increasing incidence of pediatric forearm fractures. Whereas in our study, the presentation of this fracture appeared more frequently at an early age; the typical age distribution of these fractures is bimodal; the peak incidence occurs between ages 10-14 years, coinciding with the adolescent growth spurt, with a second smaller peak incidence between 5 and 9 years of age [40]. The reasons for an increase in pediatric radius/ulna fractures remain unclear and require further investigation; it might be related to deficient bone health.…”

Section: Discussioncontrasting

confidence: 54%

“…The reasons for an increase in pediatric radius/ulna fractures remain unclear and require further investigation; it might be related to deficient bone health. Recent studies have suggested that the increased fracture risk in otherwise well children may be a function of lower bone mineralization associated with environmental factors, including physical inactivity, poor nutrition, and specific risk factors for vitamin D deficiency, such as limited sun exposure [40]. In fact, in accordance with this hypothesis, another study underlined that most of the forearm fractures were caused by minor trauma [31].…”

Section: Discussionmentioning

confidence: 97%

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Inflatable bouncer-related injuries to children: increasing phenomenon in pediatric emergency department, 2002–2013

et al. 2015

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• Along with the skyrocketing popularity of IBs among children, the number of children presenting to ED with injuries from these plays has also been increasing at an alarming rate; • The European literature about this phenomenon is scarce and no specific legislations exist for safety of these devises in European Union (EU). What is New: • This is the first study in EU that examines trends for pediatric inflatable bouncer-related injuries at ED over an 11-year period. • Although American Academy of Pediatrics recommends restrictions of attendance to IBs under 6 years old, injuries and fractures continue to occur more frequently under this age.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 97%

Inflatable bouncer-related injuries to children: increasing phenomenon in pediatric emergency department, 2002–2013

et al. 2015

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“…The majority of these fractures are successfully treated non-operatively by manipulative reduction and cast immobilization (Vopat et al. 2014, Sinikumpu and Serlo 2015). …”

mentioning

confidence: 99%

Predictive factors for re-displacement in diaphyseal forearm fractures in children—role of radiographic indices

2016

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Background and purpose — Manipulation and cast immobilization is the primary management for diaphyseal forearm fractures in children, and re-displacement is the most common complication. We wanted (1) to analyze the incidence of re-displacement in a group of children treated with close reduction and casting; (2) to determine predictive factors such as demographics, mechanism of injury, affected bone, fracture pattern, degree of initial displacement and angulation, and reduction accuracy; and (3) to determine the prognostic effect of previously defined radiographic indices.Patients and methods — We prospectively studied 269 consecutive children with closed and complete middle-third diaphyseal fractures treated with close reduction and casting from October 2014 to April 2015. Factors analyzed included demographics, initial fracture features, having a non-anatomical reduction, and the radiographic indices of cast quality.Results — There were 189 fractures of both bones (70%) and 80 solitary fractures (30%). The overall re-displacement rate was 11%. According to multivariable analysis, independent predictors of re-displacement were initial angulation >10° (RR =5) and failure to achieve an anatomical reduction (RR =2). Statistically significant radiographic indices regarding increased rate of re-displacement included cast index ≥0.7 (RR =5), Canterbury index ≥1.1 (RR =3), and 3-point index ≥0.8 (RR =6).Interpretation — Our results suggested that fractures with a higher degree of initial angulation and non-anatomical reduction more often result in re-displacement. Moreover, the casting quality examined with the radiographic indices played an important role in the success of a non-operative management.

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“…[1] We follow this as a guideline and apply cast to children below six years of age and provide plating for those above 14 years.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of forearm fractures is one in 100 and this is more common in six to 14 years of age. [1] In children, 30% of fractures occur in upper limb and among them forearm fractures accounts for 3.4% of all fractures. Among the forearm fractures, about 18% occur in the middle third.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcome of Intramedullary Nailing with Rush Pin for Pediatric Both Bone Fractures of Forearm in Western Hilly Nepal

Shrestha¹,

Byanjankar

Dwivedi³

et al. 2017

J Lumbini Med Coll

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Introduction: Both bone diaphysis fracture of forearm is common in children of hilly area in Nepal because the children climbs tree and cliff for playing and cutting grass. Close reduction and casting is the preferred method of treatment these fractures but the chances of re-displacement is very high. Intramedullary nailing with titanium elastic nails or rush pins is widely accepted these days with good outcome. Titanium nails are popular in western world but is costly whereas rush pins are cheap and are preferred in developing world. The aim of this study was to evaluate the functional outcome of intramedullary rush pin for pediatric both bone fracture of forearm. Methods: In this retrospective, observational study done from 1st of February 2017 to 31st of March 2017, a total of sixty patients with both bone fractures of forearm were treated with intramedullary rush pin and followed up for six months for evaluation of functional outcome. T-test and Chi-square tests were done. Results: Closed reduction and internal fixation was done in 48 (80%) patients. Mean age of the patients was 9.23 year (SD=2.77). Fifty-six (93.3%) patients were male with a significant difference (p<0.001). With price et al. grading system, 49 (81.7%) patients had excellent results, nine (15%) had good and two (3.3%) patients had fair results. There was no major complication. Mean time to implant removal was 24.16 weeks (SD=1.62) from the time of surgery with range of 20 to 28 weeks. Among transverse and oblique fractures, patients with transverse fracture were likely to have better outcome (p=0.04). Conclusion: Intramedullary nailing with rush pin gives excellent to good functional outcome in majority of the cases without major complications at low cost for management of both bone fractures of forearm in children.

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Treatment of diaphyseal forearm fractures in children

Cited by 52 publications

References 41 publications

Inflatable bouncer-related injuries to children: increasing phenomenon in pediatric emergency department, 2002–2013

Inflatable bouncer-related injuries to children: increasing phenomenon in pediatric emergency department, 2002–2013

Predictive factors for re-displacement in diaphyseal forearm fractures in children—role of radiographic indices

Functional Outcome of Intramedullary Nailing with Rush Pin for Pediatric Both Bone Fractures of Forearm in Western Hilly Nepal

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