Acta Ortopédica Mexicana

Reyes-Hernández LA, Cervantes-Gudiño JE, García-Diosdado A
Forearm diaphyseal fractures in pediatric patients. Review of treatment results
Acta Ortop Mex 2018; 32 (5)

Language: Español
References: 16
Page: 279-282
PDF: 153.07 Kb.

[Fulltext - PDF]

ABSTRACT

Objective: To describe the most common types of fractures in patients under 16 years of age at the forearm level, and to evaluate depending on the level of the fracture, the treatment with better results. Material and methods: We perform a retrospective analysis to determine the frequency of forearm fractures in patients under 16 years, in the period from January 2013-July 2017. The following diagnoses were entered into the system: forearm fracture, radius fracture, ulnar fracture and bilateral fracture. Results: We included 573 patients: 413 male, 160 females; right affected side: 230, left: 338, bilateral 5. Affected level: 438 distal, 102 mid-shaft and 33 proximal. The peak age of presentation was eight years. The initial treatment was conservative in 92%, followed by closed reduction and percutaneous fixation with 4.71 and 2.4% for open reduction and internal fixation with plates. There was a failed initial treatment at 3.83% when an inadequate reduction was found. Discussion: We found that the treatment of this fractures in our institution is conservative in 92%, closed reduction and percutaneous fixation in 4.71% and open reduction and internal fixation in a 2.4% being The highest prevalence in patients older than 12 years with bilateral mid-shaft fractures.


Key words: Forearm, fractures, treatment, children, results.


REFERENCES

  1. 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(3): 344-50.

  2. Jones K, Weiner DS. The management of forearm fractures in children: a plea for conservatism. J Pediatr Orthop. 1999; 19(6): 811-5.

  3. Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven years experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010; 30(4): 313-9.

  4. Mahecha-Toro M, Vergara-Amador E, González Ramírez M. Fracturas diafisarias de antebrazo en niños: tratamiento con fijación intramedular con clavos Kirschner. Rev Esp Cir Ortop Traumatol. 2018; 62(1): 71-79.

  5. Abraham A, Kumar S, Chaudhry S, Ibrahim T. Surgical interventions for diaphyseal fractures of the radius and ulna in children. Cochrane Database Syst Rev. 2011; (11): CD007907.

  6. Tachdjian MO. Ortopedia pediátrica. Madrid: Marbán; 2003, Tomo IV, 3419-21.

  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(4): 289-96.

  8. Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology of fractures in children. Injury. 2007; 38(8): 913-22.

  9. 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(4 Suppl): S200-5.

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

  11. Rodríguez-Merchán EC. Pediatric fractures of the forearm. Clin Orthop Relat Res. 2005; (432): 65-72.

  12. Canale ST, Beaty JH. Forearm Fractures. In: Campbell WC, Canale ST, Beaty JH. Campbell’s operative orthopaedics. 11th ed. Philadelphia, PA: Mosby/Elsevier; 2008.

  13. Noonan KJ, Price CT. Forearm and distal radius fractures in children. J Am Acad Orthop Surg. 1998; 6(3): 146-56.

  14. Jouve JL. Fracturas del antebrazo en el niño. Aparato locomotor. EMC. 1997: 14-045-A-10.

  15. Lobo-Escolar A, Roche A, Bregante J, Gil-Alvaroba J, Sola A, Herrera A. Delayed union in pediatric forearm fractures. J Pediatr Orthop. 2012; 32(1): 54-7.

  16. Sinikumpu JJ, Lautamo A, Pokka T, Serlo W. Complications and radiographic outcome of children’s both-bone diaphyseal forearm fractures after invasive and non-invasive treatment. Injury. 2013; 44(4): 431-6.