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Forearm Fractures

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The Pediatric Upper Extremity

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Abstract

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.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA

    Johnathan J. Whitaker

  2. Drexel University College of Medicine, Philadelphia, PA, USA

    Brandon M. Tauberg

  3. Department of Orthopaedic Surgery, Drexel University College of Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA, USA

    Michael S. Kwon & Martin J. Herman

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  1. Johnathan J. Whitaker
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  2. Brandon M. Tauberg
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  3. Michael S. Kwon
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  4. Martin J. Herman
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Correspondence to Johnathan J. Whitaker .

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Editors and Affiliations

  1. Dept. of Orthopedics, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Joshua M. Abzug

  2. Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA

    Scott H. Kozin

  3. Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA

    Dan A. Zlotolow

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Whitaker, J.J., Tauberg, B.M., Kwon, M.S., Herman, M.J. (2015). Forearm Fractures. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8515-5_49

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  • Print ISBN: 978-1-4614-8513-1

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