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J Orthop Trauma. 2012 Feb;26(2):110-6. doi: 10.1097/BOT.0b013e318216b403.

Redisplacement of diaphyseal fractures of the forearm after closed reduction in children: a retrospective analysis of risk factors.

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  • 1Department of Orthopedics, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.

Abstract

OBJECTIVES:

Manipulation and plaster fixation is the primary management for diaphyseal fractures of the radius and/or ulna in children. This study was designed to evaluate risk factors of fracture redisplacement after closed reduction and cast immobilization.

DESIGN:

Retrospective study.

SETTING:

Tertiary hospital.

PATIENTS:

Fifty-seven children with fractures of the radius were included.

INTERVENTION:

The medical records of patients with/without ulna treated with closed reduction and casting were reviewed.

MAIN OUTCOME MEASURES:

Data analyzed were age, sex, dominant hand, fracture pattern, reduction quality, experience of the surgeon, and type of anesthesia. Logistic regression was used for multivariate analysis.

RESULTS:

There were 41 (71.9%) males and 16 (28.1%) females with a mean age of 9.74 ± 3.07 years. There were 53 radius fractures and 54 ulna fractures, and 22 subjects experienced redisplacement. The redisplacement rate of radius fractures was 34% and of ulnar fractures was 27.8%. Multivariate analysis showed that the factors associated with redisplacement of radius fractures were fair reduction quality [odds ratio (OR), 8.45] and complete fracture (OR 9.62) and those for redisplacement of ulna fractures were fair reduction quality (OR 8.10) and complete fracture (OR 8.43).

CONCLUSIONS:

Poorer reduction and complete fracture are more likely to result in redisplacement, and surgical management may be considered in these cases.

[PubMed - indexed for MEDLINE]
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