Abstract
Distal radial fractures are a common injury pattern in the paediatric population. The management of displaced metaphyseal fractures introduces several controversies in management. Questions arise regarding the optimal method of stabilising these injuries following successful reduction under anaesthesia. There is a paucity of clinical evidence investigating comparative treatment effects of different interventions with only six trials being included in a Cochrane review on this topic. Trials investigating above elbow versus below elbow casts have found no difference in the re-displacement rate but demonstrated less functional restriction, earlier return to activities and reduced elbow stiffness in below elbow casts. Percutaneous wiring is associated with a lower re-displacement rate compared with cast alone treatment but does not yield a difference in functional outcome at 3 months when comparing the two treatments. Further work is required to elucidate the influence of factors such as specific fracture pattern, ulna involvement and age of the patient on long term clinical and functional outcomes following treatment to help identify which patients might benefit from surgical intervention.
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References
Worlock P, Stower M. Fracture patterns in Nottingham children. J Pediatr Orthop. 1986;6(6):656–60.
Herring JA. Tachdjian’s pediatric orthopaedics. Vol 3, 3rd ed. London: Saunders; 2002.
Abraham A, Handoll HH, Khan T. Interventions for treating wrist fractures in children. Cochrane Database Syst Rev. 2008;16(2):CD004576. doi: 10.1002/14651858.CD004576.pub2.
Gibbons CL, Woods DA, Pailthorpe C, Carr AJ, Worlock P. The management of isolated distal radius fractures in children. J Pediatr Orthop. 1994;14(2):207–10.
McLauchlan GJ, Cowan B, Annan IH, Robb JE. Management of completely displaced metaphyseal fractures of the distal radius in children. A prospective, randomised controlled trial. J Bone Joint Surg Br. 2002;84B(3):413–7.
Miller BS, Taylor B, Widmann RF, Bae DS, Snyder BD, Waters PM. Cast immobilization versus percutaneous pin fixation of displaced distal radius fractures in children. A prospective, randomized study. J Pediatr Orthop. 2005;25(4):490–4.
Boyer BA, Overton B, Schrader W, Riley P, Fleissner P. Position of immobilization for pediatric forearm fractures. J Pediatr Orthop. 2002;22(2):185–7.
Bohm ER, Bubbar V, Yong Hing K, Dzus A. Above and below-the-elbow plaster casts for distal forearm fractures in children – A randomized controlled trial. J Bone Joint Surg Am. 2006;88A(1):1–8.
Webb GR, Galpin RD, Armstrong DG. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children. J Bone Joint Surg Am. 2006;88A(1):9–17.
Chess DG, Hyndman JC, Leahey JL, Brown DC, Sinclair AM. Short arm plaster cast for distal pediatric forearm fractures. J Pediatr Orthop. 1994;14(2):211–3.
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Qureshi, A.A., Abraham, A. (2017). Evidence-Based Treatment of Wrist Fractures in Children. In: Alshryda, S., Huntley, J., Banaszkiewicz, P. (eds) Paediatric Orthopaedics. Springer, Cham. https://doi.org/10.1007/978-3-319-41142-2_37
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DOI: https://doi.org/10.1007/978-3-319-41142-2_37
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