OPEN REDUCTION AND INTERNAL-FIXATION OF PEDIATRIC FOREARM FRACTURES

Twenty-six skeletally immature patients with 27 displaced, diaphyseal forearm fractures treated by open reduction and internal fixation were reviewed. The mean age of the patients at the time of injury was 11.5 years (range, 4-15). Indications for surgery included open fractures (10), unacceptable closed reduction (14), and loss of reduction (three ). Anatomic or near anatomic fixation was achieved with either compres sion plates or intramedullary wires, The average time to union was 3.5 months. The average length of follow-up was 39 months (range, 9-98). All but three patients regained full range of motion equal to that of the uninjured extremity. Three complications occurred, including one d eep infection re suiting in delayed union, one nonunion with failure o f hardware, and one proximal radioulnar cross-union. We conclude that open reduction and internal fixation is indicated and can be safely pe rformed in children with open or unstable or both-bone forearm fractur es when closed treatment methods have failed. Fixation is reliably ach ieved with compression plating or intramedullary nailing.