Diaphyseal fractures of the ulna and radius are frequent injuries in the pediatric population. These fractures are typically the result of low-energy falls onto an outstretched hand. Nevertheless, a careful assessment of the patient is imperative, with evaluation of the skin and soft tissues for lacerations, compartment swelling, as well as a complete neurovascular examination. The majority of forearm fractures are closed injuries without associated nerve injuries or vascular compromise. These fractures are most often best treated with primary closed reduction and cast immobilization.
Forearm fractures that necessitate surgical fixation include irreducible or unstable fractures that have failed an attempt at closed reduction, open fractures, and fractures associated with severe soft tissue trauma, “floating elbow” injuries, vascular injury, or compartment syndrome. Flexible intramedullary nail fixation is the treatment of choice for most children and skeletally immature adolescents. Surgical treatment is generally associated with an increased number of complications, especially in children older than 10 years of age. Compartment syndrome, infections, nerve injuries, and extensor tendon injuries are the most common complications associated with surgical treatment. This chapter will focus on closed reduction and casting, surgical treatments, and avoidance of complications.
KeywordsTitanium Migration Depression Mold Immobilization
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