FACTORS AFFECTING FRACTURE POSITION AT CAST REMOVAL AFTER PEDIATRIC FOREARM FRACTURE

The outcome of a pediatric forearm fracture is related to the angulati on of that fracture at the time of union, We discuss the factors affec ting the position of the fracture at union, Three hundred forty-six ch ildren with 369 reductions of forearm fractures were reviewed retrospe ctively. Quality of reduction at the time of operation and loss of red uction during the period of cast immobilization were assessed using ax is deviation. Loss of reduction had a greater influence on the final p osition of the fracture at union than did the position of the fracture at initial reduction. To ensure a satisfactory outcome, all pediatric forearm fractures should be monitored with radiologic review and rema nipulation if their axis deviation is >5 in younger patients or >3 in patients with fractures close to or after growth-plate closure. Right forearm fractures in boys were identified as a subgroup al greater ris k for redisplacement.