DISTAL FOREARM FRACTURES IN CHILDREN - THE ROLE OF RADIOGRAPHS DURINGFOLLOW-UP

There is ilo consensus on the frequency of radiographic examination in the routine follow up of distal forearm fractures ill children. This study was undertaken in nn attempt to rationalize and optimize the ris e Of ionizing radiation ill these circumstances. The radiographs and c linical notes Of 325 distal forearm fractures in children were retrosp ectively studied. Degrees of initial angulation were measured from all of the radiographs performed during follow up. Comparisons of outcome were made between the fractures with initial angulation under 10 degr ees and over 10 degrees, types of fracture and the degree of reduction . Fractures with initial angulation qi <10 degrees had no clinically s ignificant evidence of re-angulation and should be considered stable r equiring only all initial diagnostic radiograph. Complete fractures, d isplaced fractures ard fractures involving both the radius and ulna re quire more careful follow rip Residual angulation after manipulation u nder anaesthetic (MUA) of 5-10 degrees was not associated with an incr eased rate of re-angulation in this study. There is no apparent advant age in performing mole than three radiographs in the majority Of eases . The authors make recommendations concerning the optimal frequency of radiography in the follow up of forearm fractures iir children. (C) 1 998 Elsevier Science Lid. Ail rights reserved.