ACCURATE PREDICTION OF OUTCOME AFTER PEDIATRIC FOREARM FRACTURE

Factors affecting outcome after pediatric forearm fracture include fra cture angulation and fracture position. A new index, axis deviation, c ombines these factors. Two review studies were performed to determine if axis deviation correlated with outcome. In the first study, 35 subj ects were reviewed 2.7 years after fracture without radiographs. In th e second study, 152 fractures were reviewed a mean of 4 years after fr acture, with 124 patients consenting to undergo radiographs. In both s tudies, the new index, axis deviation, correlated better with restrict ed forearm movement than either degree of angulation or fracture posit ion. Midshaft and distal remodeling occurred and could be predicted in terms of axis deviation. We propose that an axis deviation of <5 at t he time of union be the reduction criteria of pediatric forearm-shaft fracture regardless of fracture position.