| Long-term results following pediatric distal forearm fractures. | |
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MedLine Citation:
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PMID: 14986025 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The purpose of this retrospective study was to investigate the frequency and extent of clinical and radiological late sequelae and to identify predicting factors. MATERIALS AND METHODS: A total of 220 patients of growing age with 232 closed, conservatively treated fractures were re-examined clinically and radiologically at a median follow-up time of 10 years (range 5-16 years). Clinical and radiological findings were summarised as an overall result. RESULTS: Of the total of patients, 19% reported pain in the injured wrist, and wrist mobility was limited in 5% of patients. Forearm rotation was decreased in 16%, primarily in epiphyseal separation of the ulna ( p=0.0033). Radial inclination was different in 6% of patients, palmar tilt in 2%, and ulnar variance in 37%, compared with the contralateral side. Ulnocarpal impaction syndrome was present in 75% of the patients with positive ulnar variance. Overall outcome was excellent in 72%, good in 19%, moderate in 6%, and poor in 3% of patients. The younger the children were at the time of injury, the more favourable the results were ( p=0.009). Children who were older than 10 years when they suffered a severe fracture dislocation had the poorest results ( p=0.008). Further factors having a negative influence on outcome were repeated reduction maneuvers and an additional fracture of the ulna. CONCLUSION: Our follow-up examinations showed that the majority of patients achieved good results, especially in children under 10 years old. Large dislocations at the time of fracture healing do not influence long-term results in this age group and thus can be tolerated. Patients over 10 years old, whose fractures healed with an angular deformity of more than 20 degrees and/or fragment dislocation over half the breadth of the shaft showed the poorest results. Thus, such dislocations should not be tolerated, and reduction should be attempted in this age group by only one reduction maneuver. |
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Authors:
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Robert Zimmermann; Martin Gschwentner; Franz Kralinger; Rohit Arora; Markus Gabl; Sigurd Pechlaner |
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Publication Detail:
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Type: Journal Article Date: 2004-02-21 |
Journal Detail:
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Title: Archives of orthopaedic and trauma surgery Volume: 124 ISSN: 0936-8051 ISO Abbreviation: Arch Orthop Trauma Surg Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-04-06 Completed Date: 2004-09-28 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9011043 Medline TA: Arch Orthop Trauma Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 179-86 Citation Subset: IM |
Affiliation:
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Department of Trauma Surgery and Sports Medicine, University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Robert.Zimmermann@uklibk.ac.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Casts, Surgical Child Child, Preschool Female Forearm Injuries / therapy* Fracture Fixation / methods* Fracture Healing Fractures, Bone / therapy* Humans Infant Male Retrospective Studies Time Factors |
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