DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20194827

A study on conservative management on paediatric bone forearm fractures in tertiary care hospital in Cuddalore district

Manikandarajan ., Dinesh Raj

Abstract


Background: Diaphyseal fractures of the radius and ulna are common in the pediatric population. The standard management for pediatric forearm fractures remains conservative management with closed reduction and immobilization with an above elbow plaster cast. Though the fracture unites readily, malunion is very common. Stiffness of joints, compartment syndrome is other complications of conservative management with plaster cast Forearm fractures are common in the pediatric population. These fractures are mostly managed conservatively by means of closed manual reduction and casting. The aim of this study was to reiterate the importance of conservative management in both bone forearm fractures in the pediatric population.

Methods: This was a prospective study from a tertiary level trauma center on 70 children up to 14 years of age with both bone forearm fractures from June 2018 to June 2019, cases were obtained from medical records. Data were collected and confirmed by plain X-ray films and medical records.

Results: All fractures achieved union at the final visit. More than 90 of diaphyseal forearm fractures achieved exceptional radiological and clinical outcomes and almost no case had a significantly poor outcome. There were significantly reduced angulation deformities before and after treatment (p<0.05).

Conclusions: Nonsurgical treatment as a model of management by means of closed reduction and casting is a very well accepted method of treating pediatric diaphyseal forearm fractures. 


Keywords


Pediatric, Both bone fractures, Conservative, Casting

Full Text:

PDF

References


nails for fractures in children. J Bone Joint Surg Br. 2004;86:947-53.

Ceroni D, Martin X, Delhumeau-Cartier C, Rizzoli R, Kaelin A, Farpour-Lambert N. Is bone mineral mass truly decreased in teenagers with the first episode of forearm fracture? A prospective longitudinal study. J Pediatr Orthop. 2012;32:579-86.

Cheng JC, Ng BK, Ying SY, Lam PK. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop. 1999;19:344-50.

Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven year’s experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010;30:313-9.

Franklin CC, Robinson J, Noonan K, Flynn JM. Evidence-based medicine: management of pediatric forearm fractures. J Pediatr Orthop. 2012;32:S131-4.

Jones K, Weiner DS. The management of forearm fractures in children: a plea for conservatism. J Pediatr Orthop. 1999;19:811-5.

Khosla S, Melton LJ, 3rd, Dekutoski MB, Achenbach SJ, Oberg AL, Riggs BL. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA. 2003;290:1479-85.

Ligier JN, Metaizeau JP, Prevot J. Closed flexible medullary nailing in pediatric traumatology. Chir Pediatr. 1983;24:383-5.

Lyons RA, Delahunty AM, Kraus D, Heaven M, McCabe M, Allen H, et al. Children’s fractures: a population-based study. Inj Prev. 1999;5:129-32.

Noonan KJ, Price CT. Forearm and distal radius fractures in children. J Am Acad Orthop Surg. 1998;6:146-56.

Price CT. Acceptable alignment of forearm fractures in children: open reduction indications. J Pediatr Orthop. 2010;30:S82-4.

Quail IH, Kareem BA, Tan AB, Harwant S. Early remodeling in children’s forearm fractures. Med J Malaysia. 2001;56:34-7.

Richter D, Ostermann PA, Ekkernkamp A, Muhr G, Hahn MP. Elastic intramedullary nailing: a minimally invasive concept in the treatment of unstable forearm fractures in children. J Pediatr Orthop. 1998;18:457-61.

Rivara FP, Grossman DC, Cummings P. Injury prevention. First of two parts. N Engl J Med. 1997;337:543-8.

Ryan LM, Teach SJ, Searcy K, Singer SA, Wood R, Wright JL, et al. Epidemiology of pediatric forearm fractures in Washington, DC. J Trauma. 2010;69:S200-5.

Shah AS, Lesniak BP, Wolter TD, Caird MS, Farley FA, Vander Have KL. Stabilization of adolescent both-bone forearm fractures: a comparison of intramedullary nailing versus open reduction and internal fixation. J Orthop Trauma. 2010;24:440-7.

Sinikumpu JJ, Pokka T, Serlo W. The changing pattern of pediatric both-bone forearm shaft fractures among 86,000 children from 1997 to 2009. Eur J Pediatr Surg. 2013;23:289-96.

Tammuz NA, Abdullah S, Osman Z, Das S. Paediatric forearm fractures: functional outcome of conservative treatment. Bratisl Lek Listy. 2009;110:563-8.