Mora RFG, Espíndola CJA, Mejía RLC, López MA, Isunza RA, Hernández MS, Antonio RCE

Language: Spanish
References: 9
Page: 186-190
PDF size: 211.66 Kb.

ABSTRACT

Background: Forearm fractures in children account for 40% to 45% of all fractures in childhood; 75% to 84% are fractures of the distal third. Eighty-five percent of patients with displaced fractures present satisfactory results with closed reduction of forearm. Currently, the trend is surgical treatment of displaced fractures.
Objective: To know the result of the conservative treatment with an above-elbow cast for four to six weeks in pediatric patients with displaced fractures of forearm.
Patients and methods: We performed an observational, retrospective and descriptive study from March 2007 to March 2011 that included 927 patients with distal radial fractures (80%). Radiographs were antero-posterior and lateral to the income, post-handling and during follow-up in outpatient clinics.
Results: Displaced fractures were obtained from 130 distal radial metaphysis in sagital and/or front view in children younger than 11 years old with a minimum of 1-year follow-up. They had appropriate bone remodeling and functional recovery of forearm and wrist in all cases with conservative treatment with an above-elbow cast for four to six weeks.
Conclusions: Treatment of these fractures requires strict clinical and radiographic control mainly in the first 15 days, especially in children older than 10 years, with marked edema or initial incomplete reduction allowed, since these factors predispose a risk of redisplacement that would be unacceptable, and represent a new procedure to the patient. Conservative management remains valid even in metaphyseal fractures of the radius in pediatric patients.

REFERENCES

1. Bugarín-Arteaga S. Fracturas de antebrazo y muñeca en niños y adolescentes. Orthotips 2009;5(3):226-232.

2. Watters PW. Fracturas del radio y cúbito distal. En: Beaty JH, Kasser JR, editores. Rockwood and Wilkin’s Fracturas en el niño. Filadelfia: Lippincott Williams and Wilkins, 2005;381-442.

3. Porras CJF. Fracturas desplazadas del radio distal en niños. Fijación percutánea con clavos de Kirchner. Retos y realidades. Serie de casos. Rev Col Or Tra 2007;21(3):165-169.

4. Armtrong PE, Joughin VE, Clarke HM. Fracturas de muñeca y antebrazo. En: Green NE, Swiontkowski MF, editores. Traumatismo esquelético en niños. 2ª ed. Pensilvania: WB Saunders, 2002;161-169.

5. Davis DR, Green DP. Foramen fracture in children: pitfalls and complications. Clin Orthop 1976;120:172-183.

6. Hughston JC. Fractures of the forearm in children. J Bone Joint Surg 1962;44-A:1678.

7. Nilsson BE, Obrant K. The range of motion following fracture of the shaft of the forearm in children. Acta Orthop Scand 1977;48:600-602.

8. Olalde-Hernández M, Viveros-Arceo L. Potencial de remodelación después de una fractura de antebrazo en niños. Rev Mex Orto Ped 2008;10(1):10-13.

9. Ruiz-Osuna C, Cortés-Gomez J. Estabilidad radiométrica en pacientes con fractura metafisaria distal de radio pura y asociada a fractura cubital distal, a las dos semanas de tratamiento conservador en niños de 3 a los 17 años de edad. Rev Mex Orto Ped 2010;12(1):37-42.