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Treating Forearm Fractures in Children
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Posted on: 11/30/1999
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Falls and car accidents account for most forearm fractures in children. Treatment is based on the results of X-rays. X-rays show the amount and type of break. If the bones have moved apart the break is displaced. Surgery is usually needed to line the bones back up. This operation is called a reduction. In this study, the results of 26 children who had a percutaneous reduction are reported.
Percutaneous reduction means the surgeon inserts a small tool through the skin to use as a lever. The device is placed between the fracture fragments. The bone is elevated and pushed back in place. This method avoids making a long, open incision in order to do an open reduction.
Special X-rays used right in the operating room help the surgeon test the stability of the reduction. If the reduction is acceptable, then the arm is put in a cast for five or six weeks. X-rays are taken a week later and then at regular intervals.
All the patients in this study healed with good alignment. Three patients needed K-wires to hold the fracture in place. Two patients had slight loss of forearm motion but were unaware of it. Grip strength after healing was normal.
Closed reduction is still the preferred treatment method for all pediatric forearm fractures. This study showed that when necessary, percutaneous reduction can be used instead of an open reduction. Full recovery of forearm motion with a normal appearance is possible after fracture. This method of fracture reduction works well when only one bone in the forearm is broken or when they are both fractured.
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References:
Nusret Köse, MD, et al. Percutaneous Reduction of Irreducible Forearm Fractures in Children. In Orthopedics. July 2006. Vol. 29. No. 7. Pp. 584-586.
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