RELAPSE FRACTURE OF THE FOREARM IN CHILDR EN

In a retrospective multicenter study 28 relapse fractures of the forea rm in children were reviewed. The male to female ratio was 23:5, Six c hildren were younger than 6 years, 12 were between 6 and 10 years, and 10 were between 10 and 14 years old. The primary fracture was treated by cast fixation of 3-7 weeks duration. The refracture occurred on a average 14 weeks (4-32 weeks) after the primary fracture by a simple f all (n = 14) or a fall from height (n = 4), or during school (n = 6) o r leisure-time (n = 3) sporting activities, In 84% of the patients par tial consolidation, i.e. incomplete healing of one cortex of one or bo th forearm bones, preceded the refracture. In the majority of patients this was observed after a green stick fracture due to permanent angul ation. Six patients were operated upon for irreducibility of the relap se fracture: the others were treated by conservative means. In two pat ients a second refracture occurred. Fifteen patients were available fo r a 2 years result. Definitive angulation of more than 10 degrees caus ed a clinically relevant limitation of pro-supination in five of six p atients, To prevent relapse fractures of the forearm in children, comp lete circular consolidation of the original fracture has to be guarant eed. It remains unclear whether this is best achieved by special plast er techniques or by converting a greenstick fracture into a complete, unstable fracture.