Distal metaphyseal fractures of the forearm in children- a prospective, open, not randomized pilot study at the Diakonissen- Hospital in Flensburg

Dr.med. Miriam Adrian*, Dr. med Miriam Renkert, Dr. med Peter Halbfas, Prof. Dr. med Thorsten Lange, Prof. Dr. med. Lucas M. Wessel

Miriam Adrian, Distal metaphyseal fractures of the forearm in children- a prospective, open, not randomized pilot study at the Diakonissen- Hospital in Flensburg(2017)SDRP Journal of Anesthesia & Surgery 2(2)

Background: The metaphyseal fracture of the distal forearm is the most common fracture in childhood. Nevertheless, so far no standard guideline for the treatment of these fractures is established in Germany.                                                                 

Our objective, therefore, was to determine the criteria for conservative versus operative treatment, as well as the limiting factors for a conservative approach.

Methods: 193 patients under sixteen years of age were examined in follow-up appointments three and twelve months after a distal forearm fracture.

The kind of treatment in the first place (conservative or operative) was not dictated.

Results: As expected, all children with a torus fracture were treated conservatively. In fractures with an angulation, the treatment depended on the age of the child and on the decision of the consultant on call. The younger the child, the more often it was treated conservatively. If the malalignment/angulation was less than 20°, the children were usually treated conservatively, whereas no child with an angulation of more than 40° was treated conservatively. Twelve month after trauma there was no significant difference in function or anatomy between the two groups.

Conclusions: Although we only saw a limited number of patients, we came to the conclusion that the potential for the spontaneous correction of deformities of the distal forearm in children should be taken into account more often when deciding on a treatment plan.

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